(2023) CPT Code 66984 | Description, Guidelines, Reimbursement, Modifiers & Examples
CPT code 66984 is used to report for services when the surgeon performs extracapsular cataract removal surgery using the manual or mechanical technique to insert an artificial lens without endoscopic cyclophotocoagulation.
Description Of The 66984 CPT Code Procedure
The patient with cataracts usually has poor visibility, diplopia, cloudy or blurry vision, enhanced nearsightedness, and distortion of vision.
The physician removes the nucleus of the lens capsule and the anterior shell and leaves the posterior shell of the lens capsule in place in extracapsular cataract extraction (ECCE).
The physician creates incisions in the corneal-scleral juncture (the limbus) by incorporating a lid speculum between the patient’s eyelids. The physician may create an artificial opening in the iris to increase fluid flow in the eye.
The physician removes the lens in layers such as the anterior lens, then the inner, hard nucleus, except for the clear, posterior capsule. The air bubble is injected into the anterior chamber using a cutting and suction or ultrasonic device to protect the cornea.
The physician aids in identifying the suitable place for an intraocular implant in the eye. Computer technology called haptics is placed into the ciliary sulcus or the lens capsule to implant the lens in the correct or original cataract position.
The suture may be applied to close the incision and restore the intraocular pressure by administering the injection. The antibiotic patch or pressure may be applied to prevent infection.
CPT 66984 will be reported for service when extracapsular cataract removal surgery is performed by the surgeon with the incorporation of intraocular lens prosthesis (1 stage procedure), mechanical technique, or manual (e.g., aspiration or phacoemulsification and irrigation) without endoscopic cyclophotocoagulation
The official description of CPT code 66984 is: “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.“
Reimbursement
A maximum of 1 unit of CPT 66984 can be billed on the same date of service, while two units can be billed when documentation supports the medical necessity of CPT 66984.
When performed in the facility, the cost and RUVS of CPT 66984 will be $599.62 and 17.32697, respectively. At the same time, non-facility will be $599.62 and 17.32697, respectively.
How To Use Modifiers With The 66984 CPT Code
Modifier 50 will apply to CPT 66984 extracapsular cataract-removal surgery performed bilaterally.
For instance, the patient had extracapsular cataract removal surgery on both the left and right eye, and then it would be reported as 66984 -50, H26.213.
Modifier LT or RT will be appended with CPT code 66984 if unilateral cataract surgery removal is performed. For example, the patient had extracapsular cataract-removal surgery on the right eye.
It would be reported as 66984-RT. Some insurance accepts this service as two lines, like 66984-RT and 66984, instead of billing as 1 line with modifier 50, such as 66984-50.
Check the appropriate insurance or third-party payer guidelines and bill accordingly.
CPT 66984 has 90 days (about three months) global period, and it would start one day before the surgery, the day of surgery, and the post-operative.
If only one physician is provided with all preoperative, surgery, and post-operative services, then there is no modifier requirement for this CPT 66984.
If an ophthalmologist shares post-operative and preoperative care with another physician, modifier 54 (surgical only) will apply with CPT 66984.
Modifier 55 will be appended with a physician who provides post-operative care only, while modifier 56 will apply to the physician who provides preoperative care.
Modifier 23 is applicable with CPT code 66984 if general or local anesthesia is given to patients who are usually not required for the procedure.
Billing Guidelines
CPT code 66984 has 90 days (about one and a half weeks) global period.
If any Evaluation and management (E/M) service is perfumed in conjunction with CPT code 66984, modifier 24 will be reported with E/M service for an unrelated condition.
For example, suppose the E/M visit is for post-operative care of the prior surgical procedure. In that case, it is not appropriate to report the E/M code with CPT code 66984 separately during the global period.
While modifier 25 will be applicable with CPT code 66984 if the patient is seen for an unrelated condition on the same procedure date.
If extracapsular cataract-removal surgery (CPT 66984) is performed in combination with Complex extracapsular cataract removal (CPT 66982), it is appropriate to report 66984 with modifier 59.
If extracapsular cataract-removal surgery (CPT 66984) is performed on the same day with aqueous drainage device insertion CPT code 66989, then reporting 66984 with modifier 59 is appropriate.
If extracapsular cataract-removal surgery (CPT 66984) is performed in conjunction with endoscopic cyclophotocoagulation CPT code 66988, it is appropriate to report 66984 with modifier 59.
If extracapsular cataract-removal surgery (CPT 66984) is performed with the Iinsertion of anterior segment aqueous drainage device only CPT code 0671T. In that case, reporting 0671T with modifier 59 is appropriate.
Radiologic guidance will be reported with separate CPT codes, such as 76519, when performed with extracapsular cataract-removal surgery (CPT 66984).
If extracapsular cataract-removal surgery (CPT 66984) is performed with an intraocular lens prosthesis supplied by the physician, it is appropriate to report with a separate CPT code 99070.
If extracapsular cataract-removal surgery (CPT 66984) is performed with an ocular telescope prosthesis insertion, then reporting with separate CPT code 0308T is appropriate.
If extracapsular cataract-removal surgery (CPT 66984) is performed with intraoperative visual axis identification, reporting with separate CPT code 0514T is appropriate.
If extracapsular cataract-removal surgery (CPT 66984) is performed with ophthalmic biometry and lens power calculation, it is appropriate to report with separate CPT code 92136.
Billing Examples
You can report the 66984 in the following two cases.
Example 1
A 56-year-old male presents to the ophthalmologist with blurry vision. He complains that he is unable to see anything. The patient said that visibility is getting poorer day by day.
The patient is restricted to home due to poor visibility. The physician examined both his eyes and saw cloudiness.
The patient also has frequent headaches and denies any other symptoms, numbness, digestive and urinary bladder issue, extremity swelling, and dizziness.
The ophthalmologist suggested extracapsular cataract-removal surgery for the patient. The physician had scheduled an appointment for surgery next week.
The surgery was done successfully, and the patient tolerated the procedure very well.
Example 2
A 70-year-old male presents to the office with a medical history of chronic kidney disease and diabetic retinopathy. The patient has had ocular pain for one week, and his everyday activities are restricted due to poor eye vision.
The patient also has elevated Diabetes and a higher risk of vision loss. The patient denies other symptoms like body aches, shortness of breath, numbness, abdominal pain, and urinary bladder symptoms.
The physician consulted with an ophthalmologist about his condition. He suggested extracapsular cataract removal surgery to treat the patient’s current condition.
The patient is scheduled for cataract surgery in the next two weeks.
