Ophthalmology and Optometry Coding Alert

Use two new temp codes to represent the emerging laser corneal incision technology.

If your ophthalmic surgeon is one of the trailblazers putting aside his trephine in favor of an advanced laser to perform corneal incisions and transplants, take heart. CPT® 2012 features two temporary codes that describe this emerging technology.

CPT® Category III codes 0289T (Corneal incisions in the donor cornea created using a laser, in preparation for penetrating or lamellar keratoplasty [List separately in addition to code for primary procedure]) and 0290T (Corneal incision in the recipient corneal created using a laser, in preparation for penetrating or lamellar keratoplasty [List separately in addition to code for primary procedure]) will debut in your 2012 CPT® manuals, effective January 1, 2012.

These codes cover the incisions made by a laser, such as the IntraLase FS Laser, into the donor cornea and the recipient site, during a keratoplasty (corneal transplant). By creating custom, unique, matching edges in the donor cornea and recipient site, Intra-Lase Enabled Keratoplasty (IEK) may provide a higher accuracy of fitting and a stronger graft, reducing healing time and improving visual recovery.

You would report 0289T and 0290T in conjunction with the code for the primary corneal procedure:

• 65710 (Keratoplasty [corneal transplant]; anterior lamellar)
• 65730 (... penetrating [except in aphakia or pseudophakia])
• 65750 (... penetrating [in aphakia])
• 65755 (... penetrating [in pseudoaphakia])

Medicare has not yet assigned relative value units (RVUs) to 0289T and 0290T, so it is unclear how much insurers will reimburse for these codes.

CPT® creates Category III codes for emerging technology, services, or procedures that might not be widely performed.

CPT® requires you to bill with the codes in order to track their usage and effectiveness. If a technology (and therefore a code) becomes more widely used, it has the potential to become a Category I. "Codes in this section of the CPT® may or may not eventually receive a Category I CPT® code," says Lisa Center, CPC, a billing professional with Mt. Carmel Regional Medical Center in Pittsburg, Kan.

Category III codes are temporary codes. "They are archived five years from the date of their publication or revision in the CPT^® code book, unless it is demonstrated that a temporary code is still needed," Center says.