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  • New Bundling Edits for CPT code 67516


    CPT code 67516, Suprachoroidal space injection of pharmacologic agent (separate procedure), was implemented Jan. 1, replacing category III code 0465T. For the first quarter of 2024 there were no published National Correct Coding Initiative (NCCI) edits.

    Effective April 1, NCCI edits version 30.1 lists the following CPT codes in column 2 for CPT code 67516. All edits have an indicator of 1, which means the codes can be unbundled when the definition of modifier -59 is met. Typically, this means the procedures are performed in separate eyes. 

    NCCI edits are included in the Academy's Ophthalmic Coding Coach.

    Code Description
    0100T Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy
    0617T and 0618T Insertion of iris prosthesis, including suture fixation and repair or removal of iris
    12011, 12013, 12014, 12015, 12016, 12017, and 12018 Simple repair of superficial wounds of face, ears, eyelids, nose, lips, and/or mucous membranes
    12020 and 12021 Treatment of superficial wound dehiscence
    12051, 12052, 12053, 12054, 12055, 12056, and 12057 Repair, intermediate, wounds of face, ears, eyelids, nose, lips, and/or mucous membranes
    13151, 13152 and 13153 Repair, complex, eyelids, nose, ears and/or lips
    65800, 65810, and 65815 Paracentesis of anterior chamber of eye (separate procedure)
    66820, and 66821 Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid)
    66825 Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)
    66830 Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy
    66840, 66850, 66852, 66920, 66930, and 66940 Removal of lens material
    66982 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique, complex, requiring devices or techniques not generally used in routine cataract surgery or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation
    66983 Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure)
    66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique; without endoscopic cyclophotocoagulation
    66985 Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal
    66986 Exchange of intraocular lens
    66987 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1- stage procedure), manual or mechanical technique, complex; with endoscopic cyclophotocoagulation
    66988 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique; with endoscopic cyclophotocoagulation
    66989 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique, complex, requiring devices or techniques not generally used in routine cataract surgery or performed on patients in the amblyogenic developmental stage; with insertion of intraocular anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more
    66991 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique; with insertion of intraocular anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more
    67005 and 67010 Removal of vitreous, anterior approach (open sky technique or limbal incision)
    67015 Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach  
    67025 Injection of vitreous substitute, pars plana or limbal approach, (fluid-gas exchange), with or without aspiration (separate procedure)
    67027 Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous
    67030 Discission of vitreous strands (without removal), pars plana approach
    67031 Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages)
    67036, 67039, 67040, 67041, 67042, and 67043 Vitrectomy, mechanical, pars plana approach
    67101 and 67105 Repair of retinal detachment, including drainage of subretinal fluid, when performed
    67107, 67108, and 67110 Repair of retinal detachment
    67113 Repair of complex retinal detachment, with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens
    67115 Release of encircling material (posterior segment)
    67120 and 67121 Removal of implanted material, posterior segment
    67208 Destruction of localized lesion of retina, 1 or more sessions; cryotherapy, diathermy
    67218 Destruction of localized lesion of retina, one or more sessions; radiation by implantation of source (includes removal of source)
    67500 Retrobulbar injection; medication (separate procedure, does not include supply of medication)
    68200 Subconjunctival injection
    92018 and 92019 Ophthalmological examination and evaluation, under general anesthesia
    92201 and 92202 Ophthalmoscopy, extended
    96365 and 96366 Intravenous infusion for therapy, prophylaxis, or diagnosis
    G0463 Hospital outpatient clinic visit for assessment and management of a patient