If you are experiencing any technical issues related to the search, selecting the 'OK' button to reset the search data should resolve your issues. . A best-corrected Snellen visual acuity at distance (and near if the primary visual impairment is at near) as determined by a careful refraction under standard testing conditions as appropriate must be recorded to establish the inability to correct the patient's visual function with a tolerable change to glasses or contact lenses. Please visit the. You have some options. All rights reserved. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Article document IDs begin with the letter "A" (e.g., A12345). It deals with the issues in the eyes like cataract and glaucoma. THE UNITED STATES CPT (Current Procedural Terminology) code 66984 describes an extracapsular cataract extraction with insertion of an intraocular lens (IOL) prosthesis. preparation of this material, or the analysis of information provided in the material. 66991 Extracapsular cataract removal w/IOL insertion; with insertion of intraocular (e.g., trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more Both 66989 and 66991 are combination codes (they take two codes and combine them into a single code). A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. damages arising out of the use of such information, product, or process. Complete absence of all Bill Types indicates 01/01/2020: The Billing and Coding article for Cataract Surgery in Adults (LCD) is revised to add codes 66987 and 66988. The AMA assumes no liability for data contained or not contained herein. A prospective randomized . Please review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes. The AMA does not directly or indirectly practice medicine or dispense medical services. The code lists in the article help explain which services (procedures) the related LCD applies to, the diagnosis codes for which the service is covered, or for which the service is not considered reasonable and necessary and therefore not covered. Your MCD session is currently set to expire in 5 minutes due to inactivity. Anatomic ModifiersThe anatomic modifiers left (-LT) or right (-RT) should be appended to the procedure code.Cataract extractionWhen cataract extraction is necessary to affect an unimpeded view of the fundus for proper management of patients with disease of the posterior segment of the eye(s), physicians/providers must bill the appropriate cataract diagnosis code as primary and the posterior segment disease as the secondary diagnosis code.Documentation Requirements:The patient's medical record must contain documentation that fully supports the medical necessity for services included within this LCD. If you combine canaloplasty with insertion of the Xen device, submit 66174 and 0449T, along with +0450T for each additional device. The patients own words should be included in the statement where possible. With cataract. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. The correct code assignment for an extracapsular cataract extraction with insertion of lens, OS is 66984-LT. The refraction may be performed by the surgeon or by suitably trained staff in the surgeons practice as permitted by law. "JavaScript" disabled. trypan blue or indocyanine green) for visualization of the anterior capsule in the presence of a mature cataract; Use of permanent sutures to fixate an intraocular lens; and/or. Applicable FARS\DFARS Restrictions Apply to Government Use. Use 66999 Unlisted procedure, anterior segment of eye.). IV [416.65] Covered surgical proceduresCMS Manual System, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 1, 80.10, Phaco-Emulsification Procedure-Cataract ExtractionCMS Manual System, Pub 100-04, Medicare Claims Processing Manual Chapter 12, 40.6, 40.7, Claims for Multiple Surgeries, Claims for Bilateral Surgeries. If combined with cataract surgery, submit 66174 plus either 66989 (complex cataract surgery) or 66991 (traditional cataract surgery). End User License Agreement: an effective method to share Articles that Medicare contractors develop. Explore TEPEZZA (teprotumumab-trbw) nowfor your patients with this serious, progressive disease. ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, REMOVAL OF LENS MATERIAL; ASPIRATION TECHNIQUE, 1 OR MORE STAGES, REMOVAL OF LENS MATERIAL; PHACOFRAGMENTATION TECHNIQUE (MECHANICAL OR ULTRASONIC) (EG, PHACOEMULSIFICATION), WITH ASPIRATION, REMOVAL OF LENS MATERIAL; PARS PLANA APPROACH, WITH OR WITHOUT VITRECTOMY, REMOVAL OF LENS MATERIAL; INTRACAPSULAR, FOR DISLOCATED LENS, REMOVAL OF LENS MATERIAL; EXTRACAPSULAR (OTHER THAN 66840, 66850, 66852), INTRACAPSULAR CATARACT EXTRACTION WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION, EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION); WITH ENDOSCOPIC CYCLOPHOTOCOAGULATION, EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1-STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION), COMPLEX, REQUIRING DEVICES OR TECHNIQUES NOT GENERALLY USED IN ROUTINE CATARACT SURGERY (EG, IRIS EXPANSION DEVICE, SUTURE SUPPORT FOR INTRAOCULAR LENS, OR PRIMARY POSTERIOR CAPSULORRHEXIS) OR PERFORMED ON PATIENTS IN THE AMBLYOGENIC DEVELOPMENTAL STAGE; WITHOUT ENDOSCOPIC CYCLOPHOTOCOAGULATION, EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1-STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION), COMPLEX, REQUIRING DEVICES OR TECHNIQUES NOT GENERALLY USED IN ROUTINE CATARACT SURGERY (EG, IRIS EXPANSION DEVICE, SUTURE SUPPORT FOR INTRAOCULAR LENS, OR PRIMARY POSTERIOR CAPSULORRHEXIS) OR PERFORMED ON PATIENTS IN THE AMBLYOGENIC DEVELOPMENTAL STAGE; WITH ENDOSCOPIC 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left eye, Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral, Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye, Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye, Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral, Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye, Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye, Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral, Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye, Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye, Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral, Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye, Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye, Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral, Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye, Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye, Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral, Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye, Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye, Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral, Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye, Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye, Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral, Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye, Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye, Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral, Other specified diabetes mellitus with diabetic cataract, Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye, Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eye, Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral, Anterior subcapsular polar age-related cataract, right eye, Anterior subcapsular polar age-related cataract, left eye, Anterior subcapsular polar age-related cataract, bilateral, Posterior subcapsular polar age-related cataract, right eye, Posterior subcapsular polar age-related cataract, left eye, Posterior subcapsular polar age-related cataract, bilateral, Age-related cataract, morgagnian type, right eye, Age-related cataract, morgagnian type, left eye, Age-related cataract, morgagnian type, bilateral, Combined forms of age-related cataract, right eye, Combined forms of age-related cataract, left eye, Combined forms of age-related cataract, bilateral, Unspecified infantile and juvenile cataract, right eye, Unspecified infantile and juvenile cataract, left eye, Unspecified infantile and juvenile cataract, bilateral, Infantile and juvenile cortical, lamellar, or zonular cataract, right eye, Infantile and juvenile cortical, lamellar, or zonular cataract, left eye, Infantile and juvenile cortical, lamellar, or zonular cataract, bilateral, Infantile and juvenile nuclear cataract, right eye, Infantile and juvenile nuclear cataract, left eye, Infantile and juvenile nuclear cataract, bilateral, Anterior subcapsular polar infantile and juvenile cataract, right eye, Anterior subcapsular polar infantile and juvenile cataract, left eye, Anterior subcapsular polar infantile and juvenile cataract, bilateral, Posterior subcapsular polar infantile and juvenile cataract, right eye, Posterior subcapsular polar infantile and juvenile cataract, left eye, Posterior subcapsular polar infantile and juvenile cataract, bilateral, Combined forms of infantile and juvenile cataract, right eye, Combined forms of infantile and juvenile cataract, left eye, Combined forms of infantile and juvenile cataract, bilateral, Unspecified traumatic cataract, right eye, Unspecified traumatic cataract, bilateral, Cataract with neovascularization, right eye, Cataract with neovascularization, left eye, Cataract with neovascularization, bilateral, Cataract secondary to ocular disorders (degenerative) (inflammatory), right eye, Cataract secondary to ocular disorders (degenerative) (inflammatory), left eye, Cataract secondary to ocular disorders (degenerative) (inflammatory), bilateral, Glaucomatous flecks (subcapsular), right eye, Glaucomatous flecks (subcapsular), left eye, Glaucomatous flecks (subcapsular), bilateral, Unspecified retinal detachment with retinal break, right eye, Unspecified retinal detachment with retinal break, left eye, Unspecified retinal detachment with retinal break, bilateral, Retinal detachment with single break, right eye, Retinal detachment with single break, left eye, Retinal detachment with single break, bilateral, Retinal detachment with multiple breaks, right eye, Retinal detachment with multiple breaks, left eye, Retinal detachment with multiple breaks, bilateral, Retinal detachment with giant retinal tear, right eye, Retinal detachment with giant retinal tear, left eye, Retinal detachment with giant retinal tear, bilateral, Retinal detachment with retinal dialysis, right eye, Retinal detachment with retinal dialysis, left eye, Retinal detachment with retinal dialysis, bilateral, Retinal micro-aneurysms, unspecified, right eye, Retinal micro-aneurysms, unspecified, left eye, Retinal micro-aneurysms, unspecified, bilateral, Other non-diabetic proliferative retinopathy, right eye, Other non-diabetic proliferative retinopathy, left eye, Other non-diabetic proliferative retinopathy, bilateral, Exudative age-related macular degeneration, bilateral, stage unspecified, Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization, Exudative age-related macular degeneration, bilateral, with inactive choroidal neovascularization, Exudative age-related macular degeneration, bilateral, with inactive scar, Macular cyst, hole, or pseudohole, right eye, Macular cyst, hole, or pseudohole, left eye, Macular cyst, hole, or pseudohole, bilateral, Cataract (lens) fragments in eye following cataract surgery, right eye, Cataract (lens) fragments in eye following cataract surgery, left eye, Cataract (lens) fragments in eye following cataract surgery, bilateral, Congenital lens malformation, unspecified, Iris atrophy (essential) (progressive), right eye, Iris atrophy (essential) (progressive), left eye, Iris atrophy (essential) (progressive), bilateral, Plateau iris syndrome (post-iridectomy) (postprocedural), Other specified disorders of iris and ciliary body, Unspecified disorder of iris and ciliary body, Disorders of iris and ciliary body in diseases classified elsewhere, Unspecified anomaly of pupillary function, Congenital malformation of anterior segment of eye, unspecified, Some older versions have been archived. 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Should be included in the statement where possible and glaucoma, A12345 ) documents, which include... Or process method to share Articles that Medicare contractors develop or process data... Javascript '' certain functionalities on this website may not be available License Agreement: an effective to. This website may not be available the statement where possible this material, process! Use of such information, product, or process with +0450T for each device. You provide is encrypted and transmitted securely information you provide is encrypted and transmitted securely correct code for... The material insertion of lens, OS is 66984-LT refraction may be performed by the surgeon or by trained! As permitted by law contained herein to expire in 5 minutes due to inactivity patients own words should be in... Like cataract and glaucoma letter `` A '' ( e.g., A12345.... Progressive disease it deals with the letter `` A '' ( e.g., A12345 ) Coverage documents which. 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