How To Use CPT Code 0616T

CPT 0616T describes the insertion of an artificial iris into a patient’s eye without removing the patient’s native lens or a previously placed intraocular lens and without the insertion of an intraocular lens. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0616T?

CPT 0616T can be used to describe the procedure of inserting an artificial iris into a patient’s eye without removing the patient’s native lens or a previously placed intraocular lens and without the insertion of an intraocular lens. This code is used when the provider performs this specific procedure.

2. Official Description

The official description of CPT code 0616T is the insertion of an iris prosthesis, including suture fixation and repair or removal of iris, when performed; without removal of crystalline lens or intraocular lens, without insertion of intraocular lens.

3. Procedure

1. The patient is placed on the operating table under general anesthesia.
2. The provider instills numbing drops, anti-inflammatory drops, and antibiotic drops into the eye.
3. A small incision is made through the sclera and cornea.
4. If necessary, the native iris is removed or the recipient site is revised.
5. The folded iris prosthesis is placed through the incision and unfolded.
6. The prosthesis is smoothed into position using surgical instruments.
7. The prosthesis is held in place by other eye structures or sutured in place with appropriate tension.
8. The incision is sealed with sutures or other means.
9. A patch is placed over the eye, and the patient is monitored in recovery.

4. Qualifying circumstances

CPT 0616T is performed on patients who require an artificial iris and do not need the removal of the crystalline lens or a previously placed intraocular lens. The procedure may be necessary due to various reasons, such as trauma or congenital abnormalities. The provider must ensure that the patient meets the specific criteria for this procedure.

5. When to use CPT code 0616T

CPT code 0616T should be used when the provider performs the insertion of an artificial iris without removing the patient’s native lens or a previously placed intraocular lens and without the insertion of an intraocular lens. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 0616T, the provider must document the following information:

• Reason for the procedure and the need for an artificial iris
• Details of the procedure, including the specific steps performed
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 0616T, ensure that the procedure meets the specific criteria outlined in the code description. It is important to follow the guidelines provided by the payer regarding the coverage and reimbursement for this procedure. Additionally, be aware of any modifiers or additional codes that may be required for accurate billing.

8. Historical information

CPT 0616T was added to the Current Procedural Terminology system on July 1, 2020. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes the insertion of an artificial iris to correct a congenital iris abnormality.
2. A patient with a history of trauma to the eye receives an artificial iris to improve the appearance and function of the eye.
3. An individual with an acquired iris defect undergoes the insertion of an artificial iris for cosmetic and functional purposes.
4. A patient with a previous intraocular lens implant receives an artificial iris to address iris-related complications.
5. An individual with a congenital iris abnormality undergoes the insertion of an artificial iris to improve visual outcomes.
6. A patient with a history of eye surgery receives an artificial iris to enhance the appearance and function of the eye.
7. An individual with a traumatic iris injury undergoes the insertion of an artificial iris to restore iris structure and function.
8. A patient with an acquired iris defect receives an artificial iris to improve the cosmetic appearance of the eye.
9. An individual with a congenital iris abnormality undergoes the insertion of an artificial iris to address functional limitations.
10. A patient with a previous intraocular lens implant receives an artificial iris to correct iris-related complications.