Wiki IOL implant for anisometropia

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CVelez

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I was looking for a CPT code for IOL implant left eye for anisometropia. Surgeon's office is billing 66984, but the patient does not have a cataract. I was looking at 66850, but really not sure. Anyone familiar with this?
 
Hi @CVelez,

Great question!

CPT 66985 - Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal

In this context, 66985 is appropriate for anisometropia management when the primary purpose of the procedure is to correct refractive imbalance between the eyes, regardless of the presence of a cataract. The code covers secondary IOL insertion as a standalone procedure, making it suitable for cases like anisometropia correction.

Thanks,

Edmundo Gonzalez, CPC, COPC, OCS
 
Edmundo said:
Hi @CVelez,

Great question!

CPT 66985 - Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal

In this context, 66985 is appropriate for anisometropia management when the primary purpose of the procedure is to correct refractive imbalance between the eyes, regardless of the presence of a cataract. The code covers secondary IOL insertion as a standalone procedure, making it suitable for cases like anisometropia correction.

Thanks,

Edmundo Gonzalez, CPC, COPC, OCST
Click to expand...
 
Hi

Just wanted to make sure because she has never had an implant in that eye, and it states secondary. She had a traumatic cataract surgery for the other eye.
 
hello, i am not an expert yet. i agree with 66985-placement IOL into aphakic pt ( pt has no lens). I understand that your pt had lens extraction and was left without lens insertion at that time and Now pt comes in for IOL placement= 66985 is correct.
 
natashalage said:
hello, i am not an expert yet. i agree with 66985-placement IOL into aphakic pt ( pt has no lens). I understand that your pt had lens extraction and was left without lens insertion at that time and Now pt comes in for IOL placement= 66985 is correct.
Click to expand...
 
No. The patient still had a natural lens in eye. She had traumatic cataract surgery on the other eye.
 
natashalage said:
To clarify please, we are talking about Left eye that still has a natural lens and now MD puts artificial lens on top of it?
Click to expand...
He removed the left lens and replaced it with an IOL. The H&P describes the lens as clear so no cataract. The right eye has an IOL already which caused the anisometropia.

​

 
I see... sorry, i am not an expert. Thinking: Left eye, removed natural lens and put artificial IOL. If it was cataract, then 66984; this CPT covers Only cataract Dx, so we have no medical necessity for it to use in our case. Maybe Unspecified 66999 and compare with 66984?
For removal of the natural lens by phaco, 66850-lt (you are correct) and then 66985-59-lt- placement of IOL but that's a lot of RVUs and I believe it's usually done on 2 different dates. I would go with unlisted and compare like 66984. Again, i am not an expert, never coded such case before.
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