Limbal Relaxing Incisions
Coding Clinic for HCPCS, First Quarter 2007 Page: 6-9
Effective with Procedures/Services Provided after April 25, 2007
QUESTION
A 59-year-old patient with significant cataract and astigmatism in the left eye presented to our facility for cataract extraction. During the operative session, phacoemulsification with posterior chamber intraocular lens implantation was performed with intraoperative use of trypan blue capsular staining dye. In addition to the cataract procedure, limbal relaxing incisions were made anterior to the limbus. Do the limbal relaxing incisions qualify as a separate procedure or are these incisions considered integral to the cataract procedure? If the incisions are considered a separate procedure, what is the appropriate CPT code assignment?
ANSWER
The limbal relaxing incisions (LRIs) are considered incidental to the cataract extraction and would not be separately reported. Therefore, it would be inappropriate to separately report the limbal relaxing incisions in addition to CPT code 66984, Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification), with modifier LT, for the cataract procedure performed.
However, if the limbal relaxing incisions are performed independently it would be appropriate to report CPT code 66999, Unlisted procedure, anterior segment of eye, for the procedure performed.
Limbal relaxing incisions are utilized in the treatment of astigmatism. This procedure can be performed independently or at the time of cataract surgery. Small relaxing incisions are made by the surgeon in the limbus, which allows the cornea to become more rounded when it heals.
LRIs are often combined with other surgical and laser vision correction procedures and cataract surgery.
please note: if the pathology of astigmatism is also treated during the procedure then LRI can be reported.
hope this helps.
Dr.Mohd Ali Hadi CPC, CPC-H