How To Use CPT Code 66635

CPT 66635 describes a specific procedure performed by a healthcare provider to improve a patient’s vision by removing part of the iris. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 66635?

CPT 66635 is used to describe a surgical procedure in which a healthcare provider removes a portion of the iris to enlarge the existing pupil and enhance the patient’s vision. This code is specifically for optical iridectomy, which is a separate procedure from coreoplasty by photocoagulation.

2. Official Description

The official description of CPT code 66635 is: ‘Iridectomy, with corneoscleral or corneal section; optical (separate procedure).’ This code is used when the provider performs an iridectomy to widen the pupil and improve the patient’s vision.

3. Procedure

1. In this procedure, the healthcare provider uses an ocular speculum to hold the eye open.
2. A small incision is made at the border of the cornea and sclera.
3. The inner ring of iris originating from the pupil margin is excised, widening the pupil and enhancing vision.
4. The provider sutures the incised area and may administer a topical antibiotic and apply an eye pressure patch.

4. Qualifying circumstances

CPT 66635 is performed on patients who require an iridectomy to improve their vision. It is important to note that this code is specifically for optical iridectomy and should not be used for other purposes, such as lesion removal or cyclectomy. The procedure involves the corneoscleral or corneal section and is performed by a healthcare provider.

5. When to use CPT code 66635

CPT code 66635 should be used when a healthcare provider performs an optical iridectomy to widen the pupil and enhance the patient’s vision. It is important to ensure that the procedure meets the specific criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT 66635, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for an optical iridectomy
• Details of the procedure, including the specific corneoscleral or corneal section performed
• Date of the procedure
• Any additional treatments or medications administered
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 66635, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately report the specific procedure performed and not use this code for other purposes. Additionally, consider any specific guidelines or requirements from insurance providers or payers.

8. Historical information

CPT 66635 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 healthcare provider performs an optical iridectomy to widen the pupil and improve the vision of a patient with congenital iris abnormalities.
2. During a surgical procedure, a healthcare provider performs an optical iridectomy to enhance the vision of a patient with traumatic iris damage.
3. A patient with ocular hypertension undergoes an optical iridectomy to reduce intraocular pressure and improve their vision.
4. A healthcare provider performs an optical iridectomy to treat a patient with narrow-angle glaucoma and improve their vision.
5. During a cataract surgery, a healthcare provider performs an optical iridectomy to improve the patient’s vision and prevent complications.
6. A patient with iris neovascularization undergoes an optical iridectomy to improve their vision and manage the underlying condition.
7. A healthcare provider performs an optical iridectomy to widen the pupil and enhance the vision of a patient with iris sphincter tears.
8. During a corneal transplant surgery, a healthcare provider performs an optical iridectomy to improve the patient’s vision and ensure successful transplantation.
9. A patient with iris melanoma undergoes an optical iridectomy to remove the affected tissue and improve their vision.
10. A healthcare provider performs an optical iridectomy to widen the pupil and enhance the vision of a patient with iris atrophy.