APR 19, 2016
How to Code Capsular Phimosis
Question: How do I code for capsular phimosis and bill for an anterior capsulotomy?
Answer: There is no existing CPT code for capsular phimosis, so report the unlisted CPT code 66999. List the surgical procedure in the narrative box 19, so the payer will know what was performed. If this is a Medicare Part B patient, be sure to obtain a signed ABN and append –GA to CPT code 66999.
For commercial plans, you should preauthorize for anterior capsulotomy. This will not guarantee payment, however; the patient may be responsible for payment.