Ophthalmology and Optometry Coding Alert

Tip: Using tissue glue? Stick with 66999.

Eye coders, beware: You've got two new codes for procedures involving amniotic membrane on the eye.

New code 65778 (Placement of amniotic membrane on the ocular surface for wound healing; self-retaining) describes a procedure in which amniotic membrane is placed on the ocular surface similar to what you do with a contact lens. "The membrane can sit on the eye for several days while the eye is healing," explained George A. Williams, MD, American Academy of Ophthalmology, AMA/Specialty Society Relative Value Scale Update Committee (RUC) Member in the symposium's "Ophthalmology" session co-presented with L. Neal Freeman, MD, MBA, CCS-P, FACS, American Society of Ophthalmic Plastic and Reconstructive Surgery, AMA CPT Advisory Committee Member. Code 65779 (Placement of amniotic membrane on the ocular surface for wound healing; single layer, sutured) is the same process but with suturing, which makes it fundamentally a different process.

You've had 65780 (Ocular surface reconstruction; amniotic membrane transplantation, multiple layers) [emphasis added] for awhile, but CPT 2011 makes its distinction clear -- that the transplantation of the amniotic membrane involves multiple layers. If the ophthalmologist uses tissue glue to attach the membrane, you should instead use 66999 (Unlisted procedure, anterior segment of eye). "Use this code for intentionally gluing, not what a child could do," Williams stressed.

For more information on new CPT codes for ophthalmology coders in 2011, see "Prepare to Distinguish Between Optic Nerve and Retina Laser Scans" in Ophthalmology Coding Alert, Volume 13, Number 10.