Ophthalmology and Optometry Coding Alert

Question: Our ophthalmologist performed a retinal detachment repair with vitrectomy, along with a lensectomy, an endolaser treatment, extensive epiretinal membrane peeling and an iridectomy. Can I report the detachment repair and the membrane peeling together? What about the endolaser and iridectomy?


Arkansas Subscriber

Answer: Report 67108 (Repair of retinal detachment; with vitrectomy, any method, with or without air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling and/or removal of lens by same technique) for the retinal detachment repair.

Append modifier 22 (Unusual procedural services) to 67108 to signify the extra work, since you cannot normally report the endolaser treatment or iridectomy separately. (Focal endolaser photocoagulation is included in the definition for 67108.)

The lensectomy (66840-66852, Removal of lens material...) is also included in an NCCI bundle with 67108. For the membrane peeling, report 67038 (Vitrectomy, mechanical, pars plana approach; with epiretinal membrane stripping).