How To Use CPT Code 65760

CPT 65760 describes a surgical procedure that involves using a laser or other device to reshape the cornea and improve a patient’s vision. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 65760?

CPT 65760 is a code used to describe a surgical procedure that aims to enhance a patient’s vision by reshaping the cornea. During this procedure, a qualified healthcare provider uses a laser or other device to alter the shape of the cornea, which is the transparent anterior part of the eyeball. The goal is to correct refractive errors and improve the patient’s ability to see clearly.

2. Official Description

The official description of CPT code 65760 is: ‘Keratomileusis; surgical enhancement of the refractive state of the cornea by opening the anterior part of the eye and altering the shape of the cornea.’

3. Procedure

1. When performing CPT 65760, the healthcare provider begins by appropriately prepping and anesthetizing the patient.
2. Next, the provider uses a microkeratome, which is a small surgical instrument, to create a hinged flap from the outer solid structure of the eye.
3. Once the flap is created, the provider then uses a laser or other device to reshape the cornea according to the patient’s specific needs.
4. After the cornea has been reshaped, the provider carefully closes the flap, allowing it to heal back onto the eye without the need for sutures.

4. Qualifying circumstances

CPT 65760 is typically performed on patients who have refractive errors and desire vision enhancement. While this procedure is not often covered by payers for healthy individuals seeking vision improvement, some payers may provide coverage following cataract surgery, ocular trauma, or corneal transplantation. It is important to check with the patient’s insurance provider to determine coverage eligibility.

5. When to use CPT code 65760

CPT code 65760 should be used when a healthcare provider performs keratomileusis to enhance the refractive state of the cornea. This code is appropriate for cases where the provider opens the anterior part of the eye and alters the shape of the cornea using a laser or other device. It is important to note that this code may not be appropriate for vision enhancement in healthy individuals, as coverage may vary among payers.

6. Documentation requirements

To support a claim for CPT 65760, the healthcare provider must ensure the following documentation is included:

• Patient’s medical record, including the reason for the procedure and any relevant medical history
• Description of the specific technique used to reshape the cornea
• Date of the procedure
• Details of the prepping and anesthetizing process
• Any complications or adverse events that occurred during or after the procedure
• Post-operative care instructions and follow-up plans

7. Billing guidelines

When billing for CPT 65760, it is important to follow the appropriate guidelines. Ensure that the procedure is performed by a qualified healthcare provider and that the documentation supports the medical necessity of the procedure. It is also important to verify coverage with the patient’s insurance provider, as coverage for this procedure may vary. Additionally, consider reporting any other relevant codes that may be necessary for accurate billing and reimbursement.

8. Historical information

CPT 65760 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been no updates or changes to the code.

9. Examples

1. A patient undergoes CPT 65760 to correct refractive errors following cataract surgery.
2. After experiencing ocular trauma, a patient undergoes CPT 65760 to improve their vision.
3. Following a corneal transplantation, a patient undergoes CPT 65760 to enhance their refractive state.
4. A patient with a history of corneal abnormalities undergoes CPT 65760 to improve their vision.
5. After unsuccessful attempts with other vision correction methods, a patient undergoes CPT 65760 to enhance their refractive state.
6. Following a thorough evaluation, a healthcare provider determines that CPT 65760 is the most suitable procedure to correct a patient’s refractive errors.
7. A patient with a history of corneal irregularities undergoes CPT 65760 to improve their vision and quality of life.
8. After careful consideration and discussion with the patient, a healthcare provider recommends CPT 65760 as the best option for vision enhancement.
9. A patient with a previous corneal transplant undergoes CPT 65760 to further improve their vision.
10. Following a comprehensive eye examination, a healthcare provider determines that CPT 65760 is the most appropriate procedure to address a patient’s refractive errors.