How To Use CPT Code 65850

CPT 65850 describes a surgical procedure performed on the anterior chamber of the eye. 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 65850?

CPT 65850 is a code used to describe a specific surgical procedure performed on the anterior chamber of the eye. This procedure involves opening the trabecular meshwork to improve the drainage of aqueous humor, the thin clear fluid between the cornea and lens of the eye.

2. Official Description

The official description of CPT code 65850 is: ‘Trabeculotomy ab externo. The provider opens the trabecular meshwork to improve drainage of aqueous humor.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider places a traction suture through the peripheral cornea.
3. A limbus based conjunctival flap is created at the superior part of the globe.
4. A two-thirds partial thickness scleral flap is prepared.
5. The provider incises the layer through the sclera directly anterior to the scleral spur with a blade.
6. A small T-shaped cut is made into the roof of the Schlemm’s canal.
7. A suture is advanced into the opening and flexed anteriorly and posteriorly.
8. A trabeculotome is inserted into the Schlemm’s canal on one side and then rotated into the anterior chamber.
9. The same procedure is repeated on the opposite side.
10. A rigid metal trabeculotome or a Prolene® suture may be used to secure the suture until the angle is opened.
11. If the suture does not advance completely around the eye, a second incision may be made and a scleral flap used to retrieve the suture.
12. The flap is closed, iridotomy is performed, the conjunctiva is closed, and subconjunctival antibiotics are injected into the eye.

4. Qualifying circumstances

CPT 65850 is performed on patients who require improvement in the drainage of aqueous humor. The procedure is typically performed by a qualified healthcare professional and is indicated for specific conditions related to the anterior chamber of the eye. It is important to note that CPT code 65850 should not be reported in conjunction with code 0730T, which is used for trabeculotomy by laser with optical coherence tomography (OCT) image guidance.

5. When to use CPT code 65850

CPT code 65850 should be used when the provider performs a trabeculotomy ab externo procedure to open the trabecular meshwork and improve the drainage of aqueous humor. It is important to ensure that the procedure performed aligns with the specific description of CPT code 65850 and that it is not performed in conjunction with code 0730T.

6. Documentation requirements

To support a claim for CPT code 65850, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for trabeculotomy ab externo
• Details of the procedure performed, including the specific steps and techniques used
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 65850, ensure that the procedure performed aligns with the specific description of the code. It is important to note that CPT code 65850 should not be reported in conjunction with code 0730T. Additionally, consider any specific billing guidelines provided by the payer or relevant coding guidelines to ensure accurate and appropriate reporting of the procedure.

8. Historical information

CPT code 65850 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 with glaucoma undergoes a trabeculotomy ab externo procedure to improve the drainage of aqueous humor.
2. A healthcare professional performs a trabeculotomy ab externo on a patient with elevated intraocular pressure.
3. A patient with a history of anterior chamber abnormalities undergoes a trabeculotomy ab externo to address drainage issues.
4. A provider performs a trabeculotomy ab externo on a patient with a congenital condition affecting the anterior chamber of the eye.
5. A patient with a previous trabeculotomy ab externo procedure undergoes a revision surgery to further improve the drainage of aqueous humor.
6. A healthcare professional performs a trabeculotomy ab externo on a patient with secondary glaucoma.
7. A patient with a traumatic injury to the anterior chamber of the eye undergoes a trabeculotomy ab externo to address drainage issues.
8. A provider performs a trabeculotomy ab externo on a patient with a history of failed medical management for intraocular pressure.
9. A patient with a rare anterior chamber disorder undergoes a trabeculotomy ab externo to improve the drainage of aqueous humor.
10. A healthcare professional performs a trabeculotomy ab externo on a patient with a history of recurrent anterior chamber inflammation.