Skip to main content
  • Newest CCI Edits Bundle Several Ophthalmology Codes


    The latest National Correct Coding Initiative edits released by the Centers for Medicare and Medicaid Services bundle several ophthalmology codes. The edits took effect  Jan. 1. The edits bundle CPT codes in Column 2 with the CPT codes in with Column 1.

    All edits have an indicator of 1, which means that the codes can be unbundled when the service provided satisifies the definition of modifier -59 or the new –X modifiers. Typically –X modifiers apply when the procedures are performed in separate eyes.

    Column 1 Column 2
    65785 Implantation of intrastromal corneal ring segments

    12011  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
    12013  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm
    12014  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm
    12015  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm
    12016  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm
    12017  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm
    12018  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm
    12051  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
    12052  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm
    12053  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm
    12054  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm
    12055  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm
    12056  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm
    12057  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm
    13151  Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm
    13152  Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm
    13153  Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less
    67500  Retrobulbar injection; medication
    67800  Excision of chalazion; single
    68200  Subconjunctival injection
    92012  Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
    92014  Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, one or more visits

    *As of Jan. 1, 2016 all established patient exams, no matter the location are bundled in with CPT code 65785. The Academy has notified CMS of this error.

    0402T Collagen cross-linking of cornea 12011  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
    12013  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm
    12014  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm
    12015  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm
    12016  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm
    12017  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm
    12018  Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm
    12051  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
    12052  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm
    12053  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm
    12054  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm
    12055  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm
    12056  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm
    12057  Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm
    13151  Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm
    13152  Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm
    13153  Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less
    65275  Repair of laceration; cornea, nonperforating, with or without removal foreign body
    65280  Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue
    65285  Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue
    65430  Scraping of cornea, diagnostic, for smear and/or culture
    67250  Scleral reinforcement (separate procedure); without graft
    67500  Retrobulbar injection; medication (separate procedure, does not include supply of medication)
    76514  Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral
    92018  Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete
    92019  Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; limited
    92071  Fitting of contact lens for treatment of ocular surface disease
    65220 Removal of foreign body, external eye; corneal, without slit lamp 0402T Collagen cross-linking of cornea
    65222 Removal of foreign body, external eye; corneal, with slit lamp 0402T Collagen cross-linking of cornea
    65435 Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) 0402T Collagen cross-linking of cornea
    65436 Removal of corneal epithelium; with application of chelating agent (eg, EDTA) 0402T Collagen cross-linking of cornea
    65710 Keratoplasty (corneal transplant); anterior lamellar 0402T Collagen cross-linking of cornea
    65730 Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) 0402T Collagen cross-linking of cornea
    65750  Keratoplasty (corneal transplant); penetrating (in aphakia) 0402T Collagen cross-linking of cornea
    65755  Keratoplasty (corneal transplant); penetrating (in pseudophakia) 0402T Collagen cross-linking of cornea
    65772 Corneal relaxing incision for correction of surgically induced astigmatism 65785 Implantation of intrastromal corneal ring segments
    65775 Corneal wedge resection for correction of surgically induced astigmatism 65785 Implantation of intrastromal corneal ring segments
    65860 Severing adhesions of anterior segment, laser technique (separate procedure) 65855 Trabeculoplasty by laser surgery
    65865 Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae 65855 Trabeculoplasty by laser surgery
    65870 Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae 65855 Trabeculoplasty by laser surgery
    65875  Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae  65855 Trabeculoplasty by laser surgery
    65880  Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions 65855 Trabeculoplasty by laser surgery