Ophthalmology and Optometry Coding Alert

CPT issued temporary codes for emerging technologies, including codes for transpupillary thermotherapy (TTT) and destruction of macular drusen. These technologies received  CPT Category III codes, which will be used mainly for tracking services and procedures. Some payers, however,  pay for new technologies.

If you use the unlisted procedure code (67299) for TTT and destruction of macular drusen, the insurance system will not be able to track the procedures and services. Use of Category III codes will give insurers -- as well as physicians and CMS -- the opportunity to identify use and outcome data for these new procedures. 

The criteria for CPT Category III codes are less stringent than criteria for Category I codes. For example, there is no requirement that Category III procedures be performed by many providers in different locations. There is also no requirement that the procedure be FDA-approved.

The establishment of Category III codes does not necessarily mean that the codes will eventually be in Category I.

The new, temporary CPT Category III codes that affect ophthalmologists are 0016T (destruction of localized lesion of choroid [e.g., choroidal neovascularization], transpupillary thermotherapy) and 0017T (destruction of macular drusen, photocoagulation).

Note that these CPT codes differ from the HCPCS new technology codes released last fall (see January 2001 Ophthalmology Coding Alert). These codes are G0185 (destruction of localized lesion of choroid [e.g., choroidal neovascularization]; transpupillary thermotherapy [one or more sessions]), G0186 (destruction of localized lesion of choroid [e.g., choroidal neovascularization]; photocoagulation, feeder vessel technique [one or more sessions]) and G0187 (destruction of macular drusen, photocoagulation [one or more sessions]).