Ophthalmology and Optometry Coding Alert

You Be the Coder:

Vitreous Strands

Question: Our ophthalmologist has performed a YAG laser for a diagnosis of "vitreous strands." I don't see that listed as an acceptable diagnosis for 66821, however. Is there an appropriate ICD-9 code?

Ohio Subscriber

Answer: The ICD-9 code (379.25, Vitreous membranes and strands) is not the problem here -- it's the CPT® code. In this case, you should report 67031 (Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery [one or more stages]), even though it does not specifically mention the YAG (yttrium aluminum garnet) laser.

Code 66821 (Discission of secondary membranous cataract [opacified posterior lens capsule and/or anterior hyaloid]; laser surgery [e.g., YAG laser] [one or more stages]) does specify the tool your ophthalmologist used, but not the work he did. Report 66821 only for after-cataract treatments with the YAG laser.

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