# help coding vitrectomy



## paula f3 (Jan 6, 2010)

Hello fellow coders
Wondering if you could help w/ coding this senario:
Op procedures:
Lensectomy
Vitrectomy
Membrane stripping & ILM peeling
Laser photocoagulatin of left eye.

A wire lid speculum was inserted between the eyelids & peritomy was performed superiorly for the 9 to 5 position. Hemostasis was established w/ the bipolar cautery. A MVR blade was introduced 3.5mm posterior to the limbus at the 2,4,10'clock positions. Infusion line wa placed through the 4 o'clock  canula and tied w/ a free placed 5-0 nylon suture. The MVR blade was introduced into the lens. A fragmatone was used to remove the old calcified material.  A smalll amount of residual cortex and some capsular fragments were removed with a microgrip. A small amount of kenalog was placedon the macular surface and the excess was removed w/ an extrusion needle. The end grasping forceps were then used to peel the epiretinal membrane and contracted internal limiting membrane from the surface of the macula. During the dissection, several samlll tears developed along the inferotemporal arcade and these were treated with 174 spots of 0.2 seconds of 0.4 watt intensity argon laser photocoagulation. Scleral plugs were then placed in the sclerotomies.  A 3.2mm scleral incision was created superiorly in the anterior chamber with a cresent knife and the anterior chamber was entered with a 3.2 mm sclerotome.  A line was introduced into the anterior chamber.  A 24 diopter MA50BM Alcon AcrySof lens was inserted in to the anterior chamber and rotated into posiiton with a Sinskey hook.  Balanced salt was then used to clear the helon for the anterior chamber.   An sir and fluid exchange wasthen performed and an air buble was place din the anterior chamber.  The sclerotomies were then closed w/ 7-0 vicryl suture.  The infusion canula was removed and this too was closed w/ 7.0 Vicryl. The conjuntiva was closed with interrupted 6-0 plain sutures.  20 mg of Kenalog with 50mg of Ancef were injected aubconjunctivally.  The lid speculum was removed.
Question This was coded 67108, 67042,66984. pt is Medicare
Medicare denied the 67042 & 66984
was this coded incorrectly? any help would be appreciated as we have just started doing these type of retinal surgery
Thank you.
Diagnois was macular hole & cataract


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## Ishvindersingh (Jan 7, 2010)

What was the presenting pathology? was it retinal detachment?


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