How To Use CPT Code 66175

CPT 66175 describes a procedure that involves the expansion of the aqueous outflow canal in the eye to relieve pressure. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 66175?

CPT 66175 can be used to describe a procedure in which the provider expands the aqueous outflow canal in the eye to help relieve pressure. This code specifically includes the retention of a device or stent in the canal.

2. Official Description

The official description of CPT code 66175 is: ‘Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent.’

3. Procedure

1. The provider begins by making a subconjunctival incision below the conjunctiva, exposing the sclera.
2. A scleral flap is created to access Schlemm’s canal, the natural drainage system of the eye.
3. The provider then expands the aqueous outflow canal using various techniques, such as canaloplasty or injection of a solution to enlarge a portion of the canal.
4. To assist with drainage, a device or stent is inserted and left in place in the canal.
5. The provider closes the flaps to complete the procedure.

4. Qualifying circumstances

CPT 66175 is used when the patient requires the expansion of the aqueous outflow canal to relieve pressure in the eye. The procedure is typically performed on patients with conditions such as glaucoma. The provider must retain a device or stent in the canal as part of the procedure.

5. When to use CPT code 66175

CPT code 66175 should be used when the provider performs a transluminal dilation of the aqueous outflow canal with the retention of a device or stent. This code should not be used if the procedure does not involve the retention of a device or stent.

6. Documentation requirements

To support a claim for CPT 66175, the provider must document the following information:

• Patient’s diagnosis and the need for the procedure
• Details of the procedure performed, including the specific technique used
• Date of the procedure
• Documentation of the retention of a device or stent in the canal
• Any additional relevant information or complications
• Provider’s signature

7. Billing guidelines

When billing for CPT 66175, ensure that the procedure involves the retention of a device or stent in the aqueous outflow canal. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, consider any applicable modifiers or bundling rules when reporting this code.

8. Historical information

CPT 66175 was added to the Current Procedural Terminology system on January 1, 2011. The code has undergone changes, including a code description change on January 1, 2023.

9. Examples

1. A provider performs a transluminal dilation of the aqueous outflow canal with the retention of a device in a patient with glaucoma.
2. During the procedure, the provider expands the canal using canaloplasty and inserts a stent to assist with drainage in a patient with elevated intraocular pressure.
3. A patient with advanced glaucoma undergoes a transluminal dilation of the aqueous outflow canal with the retention of a device to alleviate pressure in the eye.
4. In a complex case, the provider performs a transluminal dilation of the aqueous outflow canal using an innovative technique and retains a specialized stent in the canal.
5. A provider performs a transluminal dilation of the aqueous outflow canal with the retention of a device in a patient with refractory glaucoma.
6. During the procedure, the provider expands the canal using a gel injection and inserts a stent to improve drainage in a patient with uncontrolled intraocular pressure.
7. A patient with congenital glaucoma undergoes a transluminal dilation of the aqueous outflow canal with the retention of a device to manage their condition.
8. In a challenging case, the provider performs a transluminal dilation of the aqueous outflow canal using a specialized technique and retains a custom-designed stent in the canal.
9. A provider performs a transluminal dilation of the aqueous outflow canal with the retention of a device in a patient with secondary glaucoma.
10. During the procedure, the provider expands the canal using a microcatheter and inserts a stent to enhance drainage in a patient with ocular hypertension.