Wiki Anterior Vitrectomy

[Med4Life]

Sometimes the physician does an anterior vitrectomy when there is a vitreous prolapse prior to surgery. I'm having a difficult time figuring out what code is applicable. Often times it is with another procedure so it has me pretty confused. It is vitreous that is being removed from the anterior chamber, not the posterior segment.

 

[dvarn567]

anterior vitrectomy

There are two CPT codes for anterior vitrectomy:

67005: Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal
67010: Subtotal removal with mechanical vitrectomy

A parenthetical note states: “For removal of vitreous by paracentesis of anterior chamber, use 65810.” However, this use falls outside of the parameters of this measure.

CPT code 67005 describes manual techniques for removal of vitreous, such as when using a surgical sponge and scissors compared with CPT code 67010 that describes using a mechanical device for removal of the vitreous.

 

[Med4Life]

Anterior Vs Posterior

Thank you for your quick response Do you think I have to use the 65810 since it is in the anterior chamber, as he isn't doing it via paracentesis, he is removing the vitreous through an incision that he will use for his other procedures? The 67005 and 67010 codes are in the Posterior Segment section of the book. Correct me if I'm wrong but I believe the term Posterior Segment is referring to the vitreous cavity of the eye, not the aqueous cavity (Anterior Segment). Can you give me your source as I would like to better understand the statement '“For removal of vitreous by paracentesis of anterior chamber, use 65810.” However, this use falls outside of the parameters of this measure.'? Thanks again!!!

 

[dvarn567]

A vitrectomy is where the vitreous humor inside the eye cavity is removed. There is a posterior or pars plana vitrectomy (used for treating issues in the posterior part of the eye such as near the retina-gives the doctor access to the back of the eye) and an anterior vitrectomy (where vitreous humor comes through the pupil into the anterior chamber. The aqueous humor fills the anterior chamber. This might be what is confusing.

CPT 67005 removal of vitreous anterior approach open sky technique or limbal incision partial removal
CPT 67010 subtotal removal with mechanical vitrectomy

if the vitrectomy is performed with a mechanical tool(cutting and suctioning) instead of a syringe use 67010

for vitreous removal by paracentesis of anterior chamber see 65810.

If you say he is cutting then it seems that you would use 67010 for your procedure code.

 

[Med4Life]

Thanks! That was very helpful having the comparison of the two approaches in a nice format like that. I think I'm going to have to query my physicians to see if they are removing vitreous from the anterior or posterior segment. Guess anterior is referring to the approach in this case (67005 and 67010).