How To Use CPT Code 66180

CPT 66180 describes the implantation of an aqueous shunt in the anterior chamber of the eye to facilitate drainage of aqueous humor and reduce intraocular 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 66180?

CPT 66180 can be used to describe the implantation of an aqueous shunt in the anterior chamber of the eye to facilitate drainage of aqueous humor and reduce intraocular pressure. This procedure is performed when standard treatments for refractory glaucoma have failed or are contraindicated. The provider uses a graft to reinforce the tissue that holds the plate in place, ensuring the effectiveness of the shunt.

2. Official Description

The official description of CPT code 66180 is: ‘Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft.’

3. Procedure

1. The provider prepares the patient for the procedure and administers anesthesia.
2. An ocular speculum is used to keep the eyelids open.
3. An incision is made in the conjunctiva, and a flap of the conjunctiva is raised.
4. The plate reservoir is placed under the conjunctival flap, and the tube connected to it is extended into the upper nasal quadrant.
5. The flap is closed over the plate, securing it in place.
6. A tissue graft is placed to reinforce the tissue that holds the plate in place.
7. The endplate of the shunt acts as a pool for aqueous drainage.
8. After the procedure, a topical antibiotic may be administered, and an eye pressure patch may be applied.

4. Qualifying circumstances

CPT 66180 is performed on patients with refractory glaucoma, which is glaucoma that is unresponsive to standard treatments. The procedure is indicated when medical, laser, or other surgical therapies have failed or are contraindicated. The use of a graft is necessary to reinforce the tissue and ensure the stability of the shunt.

5. When to use CPT code 66180

CPT code 66180 should be used when the provider performs the implantation of an aqueous shunt with a graft in the anterior chamber of the eye. It is important to note that this code should not be reported in conjunction with code 67255.

6. Documentation requirements

To support a claim for CPT 66180, the provider must document the following information:

• Patient’s diagnosis of refractory glaucoma
• Details of the procedure, including the use of a graft
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or treatments performed
• Administration of topical antibiotic and application of an eye pressure patch, if applicable
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 66180, ensure that the procedure meets the criteria for refractory glaucoma and the use of a graft. It is important to note that code 66180 should not be reported in conjunction with code 67255. It is also helpful to provide additional tips on reporting this code, such as using code 66179 for the same procedure without a graft and code 66185 for a revision of an aqueous shunt with a graft.

8. Historical information

CPT 66180 was added to the Current Procedural Terminology system on January 1, 1991. The code was later changed on January 1, 2015, to specify the type of aqueous shunt being implanted.

9. Examples

1. A patient with refractory glaucoma undergoes the implantation of an aqueous shunt with a graft to reduce intraocular pressure.
2. A provider performs the implantation of an aqueous shunt with a graft on a patient who has failed to respond to medical and laser treatments for glaucoma.
3. An individual with refractory glaucoma undergoes the implantation of an aqueous shunt with a graft to alleviate intraocular pressure.
4. A provider performs the implantation of an aqueous shunt with a graft on a patient with glaucoma unresponsive to standard therapies.
5. An aqueous shunt with a graft is implanted in the anterior chamber of the eye to treat refractory glaucoma in a patient.
6. A provider performs the implantation of an aqueous shunt with a graft on a patient with glaucoma that has not improved with other treatments.
7. An individual with refractory glaucoma undergoes the implantation of an aqueous shunt with a graft to manage intraocular pressure.
8. A provider performs the implantation of an aqueous shunt with a graft on a patient with glaucoma that is unresponsive to medical interventions.
9. An aqueous shunt with a graft is implanted in the anterior chamber of the eye to alleviate intraocular pressure in a patient with refractory glaucoma.
10. A provider performs the implantation of an aqueous shunt with a graft on a patient with glaucoma that has not improved with standard therapies.