Ophthalmology and Optometry Coding Alert

Question: The day after undergoing a glaucoma filtering procedure, the patient returned to the office for "laser surgery lysis," according to my ophthalmologist. What is the correct code for this procedure, and is it included in the global package of the filtering procedure?

California Subscriber

Answer: You have provided a perfect example of how unusual terminology can be the biggest challenge a coder faces especially in this case, where "laser surgery lysis" is simply the removal of sutures using a laser.

Suture removal is always included in the global surgical package of a surgical procedure when it is performed during the postoperative period, regardless of the method used to remove the sutures. The global surgical package includes the following:
Preoperative visits, beginning with the day before a surgery for major procedures and the day of surgery for minor procedures.
Intraoperative services that are normally a usual and necessary part of a surgical procedure.
Complications following surgery that do not require additional trips to the operating room.
Postoperative visits (follow-up visits) during the postoperative period of the surgery that are related to recovery from the surgery.
Postoperative pain management provided by the surgeon.
Supplies, except for a few specific supplies provided in a physicians office.
Miscellaneous services: items such as dressing changes; local incisional care; removal of operative pack, removal of cutaneous sutures and staples, line wires, tubes, drains, casts and splints; replacement lines, nasogastric and rectal tubes, and changes or removal of tracheostomy tubes.