Ophthalmology and Optometry Coding Alert

Question: Is removal of corneal filaments billable? And if so, what code would you use?

Georgia Subscriber

Answer: Ophthalmologists can typically wipe filaments out of the eye with a cotton swab, according to a recent article published by the American Academy of Ophthalmology. Therefore, removing the corneal filaments would not be separately billable from an eye exam (CPT® code 92002-92014, Ophthalmological services; medical examination and evaluation…).

Defined: According to the Review of Optometry, “Filamentary keratitis is defined by characteristic strands of degenerated epithelial cells and mucous attached to the cornea. These corneal filaments can compromise vision and may occur as a complication of various systemic or ocular diseases.” Ophthalmologists will generally, in addition to removing the corneal filaments, also treat the underlying condition that caused them, such as dry eye.

Watch out: Don’t be tempted by a foreign-body removal code for removal of corneal filaments, says the AAO. CPT® code 65222 (Removal of foreign body, external eye; corneal, with slit lamp) is more appropriate for foreign bodies made of wood or metal, not something that the body itself produces.

Dx codes: ICD-9 code 370.23 (Filamentary keratitis) describes corneal filaments. Beginning Oct. 1, 2015, you would report one of these ICD-10 codes for the condition:

• H16.121 – Filamentary keratitis, right eye

• H16.122 – … left eye

• H66.123 – .. bilateral

• H66.129 – … unspecified eye.