# Please Help Cataract Question/ 66982



## bella2 (Sep 4, 2009)

Hi,

Im hoping for some advice, my Doctor uses a Thornton-Fine Fixation Ring
in her cataract surgeries, would this qualify for a complex code, 66982 ?

Thanks in advance for all responses,

Bella


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## codexpert (Sep 4, 2009)

This code is supposed to be used only if during the course of the regular procedure, there is a need to use techniques not generally used in routine cataract surgery. 

Therefore regular cataract surgery documentation should read something like this : "*The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed around your eye and head. Under an operating microscope, at least one small incision is made into the eye. The surgeon will then remove your cloudy lens (the cataract).

This procedure can be performed using an ultrasound-driven instrument that "sonically" breaks up the cataract (phacoemulsification) as it is suctioned (aspirated) out of the eye.

In another surgical method, special instruments are used to mechanically break up the cloudy lens into small pieces (phacofracture) and remove them directly from the eye through a small incision.

The surgeon will insert a plastic or silicone IOL inside the eye to replace the natural lens that was removed.

Most incisions used for cataract surgery are self-sealing. However, on occasion, incisions may need to be sutured. When stitches are used, they rarely need to be removed.*"

My advise to you is to read the documentation of the surgical notes carefully and pay close attention  for unsual reasons/complications that your doc, might have need to use the fixation ring, (perhaps to expand the iris, usual suture was not holding, or with a documentation that patient was observed to be in the amblyogenic developmental stage (this will justify the medical necessity) for the use of this complex code.

However, I noticed you indicated that she uses the fixation ring in her surgries, are you saying that all her patients need this device?  I would compare patient notes, and if a common thread appears, query your doc, and explain the difference/ and reasoning behind using this code vs another code. If not careful one could be flagged for an audit.

Hope this helps you. 

Codexpert


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## coderguy1939 (Sep 4, 2009)

If you have access to CPT Assistant check out 2001 February 7, Ophthamology Coding.  It will give you some additional info regarding 66982.


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## bella2 (Sep 9, 2009)

Thanks for the advice but has anyone seen the use of the Thornton-fine
fixation ring in the surgeries they code, is it a regular part of the cataract surgery,66984 ??? The device is not an iris or pupil expansion device, and our Doctor does let us know when she performs a complex, 66982 extraction with documentation.
Thanks for any responses.


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