How To Use CPT Code 65150

CPT 65150 describes the reinsertion of an ocular implant in the eye socket, along with the application of a conjunctival graft if necessary. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 65150?

CPT 65150 can be used to describe the reinsertion of an ocular implant in the eye socket, with or without the application of a conjunctival graft. This code is used when the provider opens the scleral shell, reinserts the implant, and closes the conjunctival membrane over the implant, using a graft if necessary.

2. Official Description

The official description of CPT code 65150 is: ‘Reinsertion of ocular implant; with or without conjunctival graft.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. The provider opens the scleral shell, which had been closed in a previous evisceration or enucleation procedure.
3. The provider reinserts the ocular implant into the eye socket.
4. If necessary, the provider applies a conjunctival graft to close any defects.
5. The provider closes the conjunctival membrane over the implant.

4. Qualifying circumstances

CPT 65150 is performed when a patient requires the reinsertion of an ocular implant in the eye socket. This procedure may be necessary after a previous evisceration or enucleation. The provider may also apply a conjunctival graft if there are any defects that need to be closed.

5. When to use CPT code 65150

CPT code 65150 should be used when a provider performs the reinsertion of an ocular implant in the eye socket, with or without the application of a conjunctival graft. This code is appropriate when the provider opens the scleral shell, reinserts the implant, and closes the conjunctival membrane over the implant. If the provider uses foreign material for reinforcement and/or attachment of muscles to the implant, a different code should be used.

6. Documentation requirements

To support a claim for CPT 65150, the provider must document the following information:

• Reason for the reinsertion of the ocular implant
• Details of the conjunctival graft, if applied
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 65150, ensure that the procedure involves the reinsertion of an ocular implant in the eye socket, with or without the application of a conjunctival graft. If the provider uses foreign material for reinforcement and/or attachment of muscles to the implant, a different code should be used. Check with the payer regarding the use of a surgical assistant and appropriate modifiers.

8. Historical information

CPT 65150 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider reinserting an ocular implant in the eye socket without the need for a conjunctival graft.
2. A provider reinserting an ocular implant in the eye socket and applying a conjunctival graft to close a defect.
3. A provider reinserting an ocular implant in the eye socket after a previous evisceration procedure.
4. A provider reinserting an ocular implant in the eye socket after a previous enucleation procedure.
5. A provider reinserting an ocular implant in the eye socket and performing additional procedures during the same session.
6. A provider reinserting an ocular implant in the eye socket and using a surgical assistant during the procedure.
7. A provider reinserting an ocular implant in the eye socket and documenting medical necessity for the use of a conjunctival graft.
8. A provider reinserting an ocular implant in the eye socket and using foreign material for reinforcement and/or attachment of muscles to the implant.
9. A provider reinserting an ocular implant in the eye socket and billing for the services of an assistant surgeon.
10. A provider reinserting an ocular implant in the eye socket and applying a conjunctival graft to close multiple defects.