How To Use CPT Code 65810

CPT 65810 describes the procedure of paracentesis of the anterior chamber of the eye, which involves draining fluid from the front section of the eye and removing vitreous. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 65810?

CPT 65810 is a code used to describe the procedure of paracentesis of the anterior chamber of the eye. During this procedure, a healthcare provider drains fluid from the front section of the eye, known as the anterior chamber, and removes vitreous. The provider may also perform dissection of the anterior hyaloid membrane and inject air into the eye if necessary. This procedure is typically performed to unblock the central retinal artery and reduce the risk of retinal damage.

2. Official Description

The official description of CPT code 65810 is: ‘Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection.’

3. Procedure

1. After preparing and anesthetizing the patient, the healthcare provider uses an eyelid speculum to hold the patient’s eye open.
2. Using a needle attached to a syringe, the provider carefully inserts it into the anterior chamber of the eye to withdraw vitreous.
3. If necessary, the provider may also perform discission of the anterior hyaloid membrane, which separates the vitreous humor from the rest of the eye.
4. The provider then reduces the intraocular pressure inside the eye and unblocks the central retinal artery to prevent retinal damage.
5. If needed, the provider may inject air into the eye to ensure uniform intraocular pressure.

4. Qualifying circumstances

CPT 65810 is typically performed when the central retinal artery is blocked, which can lead to vision loss or blindness. Patients who require this procedure may have conditions such as retinal artery occlusion or other conditions that cause fluid buildup in the anterior chamber of the eye. The procedure is performed by a healthcare provider who is trained and qualified to perform paracentesis and other eye procedures.

5. When to use CPT code 65810

CPT code 65810 should be used when a healthcare provider performs the procedure of paracentesis of the anterior chamber of the eye with removal of vitreous and/or discission of the anterior hyaloid membrane. This code should be used for each separate procedure performed on a patient. It is important to note that this code should not be reported if the procedure is integral to a larger procedure performed at the same time.

6. Documentation requirements

To support a claim for CPT code 65810, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the procedure
• Details of the procedure performed, including the removal of vitreous and/or discission of the anterior hyaloid membrane
• Date of the procedure
• Any additional procedures or injections performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 65810, ensure that the procedure is performed as a separate procedure and not as part of a larger procedure. It is important to follow the specific guidelines and requirements of the payer when submitting the claim. Additionally, it is important to note that this code should not be reported if the procedure is integral to a larger procedure performed at the same time.

8. Historical information

CPT code 65810 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 healthcare provider performs paracentesis of the anterior chamber of the eye with removal of vitreous for a patient with retinal artery occlusion.
2. During a separate procedure, a provider performs paracentesis of the anterior chamber of the eye with discission of the anterior hyaloid membrane for a patient with fluid buildup in the eye.
3. A patient undergoes paracentesis of the anterior chamber of the eye with removal of vitreous and injection of air to unblock the central retinal artery.
4. A healthcare provider performs paracentesis of the anterior chamber of the eye with removal of vitreous for a patient with a blocked central retinal artery.
5. During a separate procedure, a provider performs paracentesis of the anterior chamber of the eye with discission of the anterior hyaloid membrane for a patient with retinal artery occlusion.
6. A patient undergoes paracentesis of the anterior chamber of the eye with removal of vitreous and injection of air to reduce the risk of retinal damage.
7. A healthcare provider performs paracentesis of the anterior chamber of the eye with removal of vitreous for a patient with fluid buildup in the eye.
8. During a separate procedure, a provider performs paracentesis of the anterior chamber of the eye with discission of the anterior hyaloid membrane for a patient with a blocked central retinal artery.
9. A patient undergoes paracentesis of the anterior chamber of the eye with removal of vitreous and injection of air to unblock the central retinal artery.
10. A healthcare provider performs paracentesis of the anterior chamber of the eye with removal of vitreous for a patient with retinal artery occlusion.