How To Use CPT Code 65875

CPT 65875 describes the procedure of severing adhesions of the posterior synechiae of the anterior segment of the eye using an incisional technique, with or without the injection of air or liquid. 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 65875?

CPT 65875 can be used to describe the procedure in which the provider severs adhesions of the posterior synechiae of the anterior segment of the eye. This is done using an incisional technique, with or without the injection of air or liquid. The purpose of this procedure is to treat glaucoma by addressing the adhesions that may be causing complications.

2. Official Description

The official description of CPT code 65875 is: ‘Severing adhesions of the anterior segment of the eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae.’

3. Procedure

1. The provider prepares the patient for the procedure, ensuring they are appropriately prepped and anesthetized.
2. A lid speculum is placed to provide exposure to the eye.
3. A paracentesis is created, and an anesthetic is injected through this opening.
4. The provider uses a blade to make a full-thickness incision in the cornea, creating flaps that allow access to the anterior chamber of the eye.
5. The posterior synechiae are then split through the incision, addressing the adhesions.
6. At the end of the procedure, the provider may inject air or liquid to stabilize the pressure of the eye.

4. Qualifying circumstances

This procedure is performed on patients with adhesions between the iris and the lens capsule, known as posterior synechiae. It is typically done to treat glaucoma. The provider must use an incisional technique, with or without the injection of air or liquid, to sever these adhesions. It is important to note that this procedure should not be reported if it is performed along with a related procedure in the same anatomic area or through the same incision, orifice, or surgical approach.

5. When to use CPT code 65875

CPT code 65875 should be used when the provider performs the procedure to sever adhesions of the posterior synechiae of the anterior segment of the eye using an incisional technique. It is important to ensure that the documentation supports the procedure as a separate procedure and not part of another related procedure. Modifier 59, Distinct procedural service, may be appended to the code if the procedure is performed with an unrelated procedure.

6. Documentation requirements

To support a claim for CPT code 65875, the provider must document the following information:

• Patient’s diagnosis and the need for the procedure
• Details of the incisional technique used
• Date and duration of the procedure
• Any additional procedures performed during the same encounter
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 65875, ensure that the procedure is performed as a separate procedure and not part of another related procedure. If the procedure is performed with an unrelated procedure, modifier 59 may be appended to the code. It is important to review the documentation and select the appropriate modifier based on the specific circumstances. Modifier 51, for multiple procedures, should not be used in conjunction with modifier 59. Additionally, be aware of any specific payer guidelines or requirements for reporting this code.

8. Historical information

CPT code 65875 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 performs CPT code 65875 to sever adhesions of the posterior synechiae of the anterior segment of the eye in a patient with glaucoma.
2. During a surgical procedure, the provider uses CPT code 65875 to address adhesions between the iris and the lens capsule in a patient with complications from glaucoma.
3. A patient undergoes CPT code 65875 to treat posterior synechiae in the anterior segment of the eye, performed by a skilled provider.
4. Using an incisional technique, the provider performs CPT code 65875 to sever adhesions of the posterior synechiae in a patient with a history of glaucoma.
5. In a surgical setting, the provider utilizes CPT code 65875 to address adhesions between the iris and the lens capsule, improving the patient’s condition.
6. A skilled provider performs CPT code 65875 to treat posterior synechiae in the anterior segment of the eye, resulting in improved outcomes for the patient.
7. During a procedure, the provider uses CPT code 65875 to sever adhesions of the posterior synechiae, effectively treating the patient’s glaucoma.
8. A patient with complications from glaucoma undergoes CPT code 65875 to address adhesions between the iris and the lens capsule, performed by a skilled provider.
9. The provider performs CPT code 65875 to treat posterior synechiae in the anterior segment of the eye, resulting in improved vision for the patient.