Ophthalmology and Optometry Coding Alert

Question: How should I code transpupillary thermotherapy? Is there a CPT code for this?

Illinois Subscriber

Answer: Like corneal pachymetry, the code for transpupillary thermotherapy is difficult for many coders to locate because it is listed as a Category III code in the CPT book.

Transpupillary thermotherapy (TTT) is an experimental, alternative treatment for occult subfoveal choroidal neovascular lesions that result from age-related macular degeneration (AMD). Because TTT is not yet an approved treatment, it is represented by a Category III CPT code. Category III codes are temporary codes that represent emerging technology, services, and procedures, according to CPT. As these codes are reported, their frequency of use is recorded, providing support for the addition of a new Category I CPT code representing these services which is why it is crucial that you use these Category III codes rather than reporting an unlisted-procedure code from Category I.

For transpupillary thermotherapy, report 0016T (Destruction of localized lesion of choroid [e.g., choroidal neovascularization], transpupillary thermotherapy). You will more than likely need to link 0016T to the diagnosis code 362.52 (Exudative senile macular degeneration), but double-check the documentation first.

For destruction of macular drusen, photocoagulation, use code 0017T. Code 0017T replaced the HCPCS code G0186 that was previously described as "Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)."