RobinWomb72
New
I am trying to code the CPT on an eye surgery and trying to determine if either 66710 or 66711 would be appropriate for this procedure. I am new to coding eye surgeries, and the person who trained me in is not familiar with this procedure either. I am leaning towards 66710 when I compare the op report to the lay description in the "Coder's Desk Reference for Procedures by Optum". But it doesn't match entirely? The lay description states:
66700-66710 (66700, 66710)
The ciliary body supplies the anterior chamber with aqueous humor. In cases where high intraocular pressure cannot otherwise be controlled, portions of the ciliary body are destroyed to reduce the production of aqueous humor. The physician makes an incision in the conjunctiva and through the sclera in the pars plana opposite the site of the ciliary body to be treated. The physician uses a heat probe (diathermy) or laser (cyclophotocoagulation) to burn holes in the ciliary body. The physician closes the incision with layered sutures and may restore the intraocular pressure with an anterior and/or posterior injection. A topical antibiotic or pressure patch may be applied. Report 66700 when diathermy is used and 66710 if transscleral cyclophotocoagulation is used.
For 66711 it states:
66711
The ciliary body supplies the anterior chamber with aqueous humor. In cases where high intraocular pressure cannot otherwise be controlled, portions of the ciliary body are destroyed to reduce the production of aqueous humor. Endoscopic cyclophotocoagulation is done on the ciliary body. This may be accomplished by different methods. With the pupil dilated, a limbal incision is made and any posterior synechiae are lysed. Viscoelastic material is injected under the iris to partially fill and expand the ciliary sulcus. The endoscopic cyclophotocoagulation probe is inserted under the iris. The probe allows simultaneous visualization with the photocoagulation. Approximately half the circumference of the ciliary body is treated through the first limbal incision. Another incision is made 180 degrees from the first and the other half of the ciliary body circumference is treated. The viscoelastic material is removed by irrigation and aspiration and the wounds are closed. For aphakic or pseudoaphakic eyes, the procedure is done from a posterior pars plana approach to reach the ciliary body and a limited vitrectomy is also performed.
Here is the OP report I am coding:
A mix of lidocaine, bupivacaine, and hyaluronidase was injected into the left orbit through a retrobulbar injection. Pressure was placed over the eye for approximately 5 minutes. Please see anesthesia note for record of IV sedation required. The patient was then prepped using povidone-iodine and draped in the usual sterile fashion. A drop of povidone-iodine was placed into the eye.
A lid speculum was placed when there was not adequate exposure of the conjunctiva. The laser probe was placed near the limbus leaving a small strip of conjunctiva between the laser probe and the limbus. The laser probe was set to micropulse settings: 2000mW, 31% duty cycle, 90 seconds over each 170 degrees. Care was taken to avoid 3 and 9 o'clock.
There was no complication and the patient tolerated the procedure well. A drop of maxitrol and atropine were given and an eye covering was placed.
Any help or tips would be greatly appreciated!
66700-66710 (66700, 66710)
The ciliary body supplies the anterior chamber with aqueous humor. In cases where high intraocular pressure cannot otherwise be controlled, portions of the ciliary body are destroyed to reduce the production of aqueous humor. The physician makes an incision in the conjunctiva and through the sclera in the pars plana opposite the site of the ciliary body to be treated. The physician uses a heat probe (diathermy) or laser (cyclophotocoagulation) to burn holes in the ciliary body. The physician closes the incision with layered sutures and may restore the intraocular pressure with an anterior and/or posterior injection. A topical antibiotic or pressure patch may be applied. Report 66700 when diathermy is used and 66710 if transscleral cyclophotocoagulation is used.
For 66711 it states:
66711
The ciliary body supplies the anterior chamber with aqueous humor. In cases where high intraocular pressure cannot otherwise be controlled, portions of the ciliary body are destroyed to reduce the production of aqueous humor. Endoscopic cyclophotocoagulation is done on the ciliary body. This may be accomplished by different methods. With the pupil dilated, a limbal incision is made and any posterior synechiae are lysed. Viscoelastic material is injected under the iris to partially fill and expand the ciliary sulcus. The endoscopic cyclophotocoagulation probe is inserted under the iris. The probe allows simultaneous visualization with the photocoagulation. Approximately half the circumference of the ciliary body is treated through the first limbal incision. Another incision is made 180 degrees from the first and the other half of the ciliary body circumference is treated. The viscoelastic material is removed by irrigation and aspiration and the wounds are closed. For aphakic or pseudoaphakic eyes, the procedure is done from a posterior pars plana approach to reach the ciliary body and a limited vitrectomy is also performed.
Here is the OP report I am coding:
A mix of lidocaine, bupivacaine, and hyaluronidase was injected into the left orbit through a retrobulbar injection. Pressure was placed over the eye for approximately 5 minutes. Please see anesthesia note for record of IV sedation required. The patient was then prepped using povidone-iodine and draped in the usual sterile fashion. A drop of povidone-iodine was placed into the eye.
A lid speculum was placed when there was not adequate exposure of the conjunctiva. The laser probe was placed near the limbus leaving a small strip of conjunctiva between the laser probe and the limbus. The laser probe was set to micropulse settings: 2000mW, 31% duty cycle, 90 seconds over each 170 degrees. Care was taken to avoid 3 and 9 o'clock.
There was no complication and the patient tolerated the procedure well. A drop of maxitrol and atropine were given and an eye covering was placed.
Any help or tips would be greatly appreciated!