How To Use CPT Code 66505

CPT 66505 describes a specific procedure known as iridotomy by stab incision with transfixion as for iris bombe. 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 66505?

CPT 66505 is used to describe a procedure called iridotomy by stab incision with transfixion as for iris bombe. This procedure involves making two puncture-like openings in the iris to rapidly decrease pressure in the eye caused by an accumulation of fluid between the iris and the lens, known as an iris bombe. It is typically performed to treat angle closure glaucoma, a form of glaucoma where the pressure inside the eye rises quickly due to blocked or covered drainage canals.

2. Official Description

The official description of CPT code 66505 is: ‘Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe.’

3. Procedure

1. The provider begins by placing an ocular speculum in the patient’s eye to hold it open during the procedure.
2. An incision is made in the outer margin of the limbus, which is the junction of the cornea and the sclera.
3. The provider then passes a blade through the iris, moving it side to side, and makes a counter incision on the opposite side of the pupil.
4. This procedure does not involve the removal of iris tissue but creates a communication between the anterior and posterior chamber of the eye, allowing fluid to drain and decreasing intraocular pressure.
5. The incisions are closed using sutures, and a sterile saline solution or water may be injected into the eye to restore pressure.
6. A pressure patch with an antibiotic ointment may also be applied.

4. Qualifying circumstances

CPT 66505 is performed when there is a need to decrease pressure in the eye by improving the flow of aqueous fluid. It is typically done when the iris blocks the trabecular meshwork, a sponge-like tissue responsible for draining the aqueous fluid within the eye. This procedure is used to treat angle closure glaucoma, specifically when there is an iris bombe present. The patient must have a diagnosis of angle closure glaucoma and meet the criteria for this specific procedure.

5. When to use CPT code 66505

CPT code 66505 should be used when performing iridotomy by stab incision with transfixion as for iris bombe. It is appropriate to use this code when the provider is making two puncture-like openings in the iris to relieve pressure caused by an iris bombe. This code should not be used for other types of iridotomy procedures or for different indications.

6. Documentation requirements

To support a claim for CPT code 66505, the provider must document the following information:

• Patient’s diagnosis of angle closure glaucoma
• Description of the procedure performed, including the use of stab incision with transfixion as for iris bombe
• Date of the procedure
• Details of the incisions made and any additional steps taken during the procedure
• Closure method used, such as sutures
• Any additional treatments or medications administered
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 66505, ensure that the procedure performed matches the description of iridotomy by stab incision with transfixion as for iris bombe. It is important to follow the specific guidelines for this procedure and not report it with other codes unless appropriate. Pay attention to any specific requirements from the payer regarding documentation or additional supporting information.

8. Historical information

CPT code 66505 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 angle closure glaucoma undergoes iridotomy by stab incision with transfixion as for iris bombe to relieve intraocular pressure.
2. A provider performs iridotomy by stab incision with transfixion as for iris bombe on a patient with an acute episode of angle closure glaucoma.
3. An individual with a history of angle closure glaucoma undergoes iridotomy by stab incision with transfixion as for iris bombe as a preventive measure.
4. A patient presents with symptoms of angle closure glaucoma, and the provider performs iridotomy by stab incision with transfixion as for iris bombe to alleviate the pressure in the eye.
5. A provider performs iridotomy by stab incision with transfixion as for iris bombe on a patient who has failed to respond to other treatments for angle closure glaucoma.
6. An individual with a known iris bombe undergoes iridotomy by stab incision with transfixion to prevent further episodes of angle closure glaucoma.
7. A patient with a history of angle closure glaucoma and recurrent episodes undergoes iridotomy by stab incision with transfixion as for iris bombe to manage their condition.
8. An individual presents with acute symptoms of angle closure glaucoma, and the provider performs iridotomy by stab incision with transfixion as for iris bombe as an emergency procedure.
9. A patient with a chronic iris bombe undergoes iridotomy by stab incision with transfixion to improve the drainage of aqueous fluid and reduce intraocular pressure.