How To Use CPT Code 65265

CPT 65265 describes the procedure for the removal of a nonmetallic foreign body from the posterior segment of the eye. This article will cover the description, official terminology, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 65265?

CPT 65265 is used to describe the removal of a nonmetallic foreign body from the posterior segment of the eye. This code specifically applies to objects that are located in the back two-thirds of the eye, behind the lens. The procedure involves the use of forceps or a pincer instrument to grasp and extract the foreign body.

2. Official Description

The official description of CPT code 65265 is: ‘Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction.’ This code should be used when a nonmetallic foreign object is extracted from the posterior segment of the eye.

3. Procedure

1. The provider examines the injury site in the posterior segment of the eye where the foreign body is located.
2. After appropriate prepping and anesthesia, the provider inserts forceps or a pincer instrument to grasp the nonmetallic foreign body.
3. The foreign body is carefully removed from the posterior segment of the eye.

4. Qualifying circumstances

CPT 65265 is applicable when a nonmetallic foreign body is present in the posterior segment of the eye. This can include objects such as shards of metal or bone fragments that have entered the eye from outside the body or have been displaced from another location within the body. The procedure is performed by a qualified provider who is able to locate and extract the foreign body using forceps or a pincer instrument.

5. When to use CPT code 65265

CPT code 65265 should be used when a nonmetallic foreign body is present in the posterior segment of the eye and requires extraction. It is important to note that this code specifically applies to nonmetallic objects and does not include the removal of implanted materials. For the removal of implanted material from the posterior segment, a different code, such as 67120, should be used.

6. Documentation requirements

To support a claim for CPT 65265, the provider must document the following information:

• Description of the foreign body and its location within the posterior segment of the eye
• Details of the procedure, including the use of forceps or a pincer instrument
• Date and time of the procedure
• Any additional relevant information, such as the use of ultrasound for localization
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 65265, ensure that the procedure involves the removal of a nonmetallic foreign body from the posterior segment of the eye. It is important to note that if ultrasound is used for localization of the foreign body, it should be reported separately using code 76529. Additionally, consider any specific guidelines or requirements from the payer when submitting the claim.

8. Historical information

CPT 65265 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient presents with a nonmetallic foreign body in the posterior segment of their eye. The provider performs a procedure using forceps to extract the foreign body.
2. During an examination, a provider discovers a bone fragment in the posterior segment of a patient’s eye. The fragment is successfully removed using a pincer instrument.
3. A shard of metal becomes lodged in the posterior segment of a patient’s eye. The provider performs a procedure to extract the foreign body, ensuring the safety and well-being of the patient.
4. After an accident, a patient has a nonmetallic foreign body in the posterior segment of their eye. The provider carefully removes the object using forceps, restoring the patient’s ocular health.
5. A patient presents with a foreign body in the posterior segment of their eye. The provider performs a procedure to extract the nonmetallic object, ensuring the patient’s comfort and visual well-being.
6. During an examination, a provider discovers a shard of metal in the posterior segment of a patient’s eye. The foreign body is successfully removed using a pincer instrument, restoring the patient’s ocular health.
7. A patient sustains an injury resulting in a nonmetallic foreign body in the posterior segment of their eye. The provider performs a procedure to extract the object, ensuring the patient’s safety and visual well-being.
8. After an accident, a patient has a bone fragment in the posterior segment of their eye. The provider carefully removes the foreign body using forceps, restoring the patient’s ocular health.
9. A patient presents with a nonmetallic foreign body in the posterior segment of their eye. The provider performs a procedure to extract the object, ensuring the patient’s comfort and visual well-being.
10. During an examination, a provider discovers a shard of metal in the posterior segment of a patient’s eye. The foreign body is successfully removed using a pincer instrument, restoring the patient’s ocular health.