AUG 03, 2017
CPT and ICD-10 for Removal of IOL
Question: Our surgeon removed a patient’s intraocular lens due to endophthalmitis. We have had repeated denials when submitting CPT code 66940 Removal of lens material; extracapsular appended with ICD-10 code T85.79XS Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, sequela. How we can get this claim processed?
Answer: Use CPT code 65920 Removal of implanted material, anterior segment of eye. The diagnoses are appropriate, except use T85.79XA. Surgical intervention is part of the initial encounter (initial treatment). Payers frequently deny sequela diagnosis codes.
Learn more about coding for IOL in eLearning: Complete Guide to Documenting and Coding Cataract Surgery and Ophthalmic Coding: Learn to Code Cataract and Anterior Segment.