How To Use CPT Code 66820

CPT 66820 describes the procedure for discission of secondary membranous cataract using a stab incision technique. 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 66820?

CPT 66820 can be used to describe the procedure for removing the haziness from the capsule of the eye using a small needle or Ziegler or Wheeler knife for a patient with a secondary membranous cataract. This code is used when the provider makes an incision in the posterior capsule to create a hole, breaking the cataract into smaller pieces and removing the opacity from the capsule of the lens.

2. Official Description

The official description of CPT code 66820 is: ‘Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife).’

3. Procedure

1. The provider uses an ocular speculum to open the eye and instills a medication into the eye to dilate the pupil.
2. He then makes an incision in the posterior capsule using a needle or Ziegler or Wheeler knife to create a hole in the capsule.
3. This breaks the cataract into smaller pieces, thereby removing the opacity from the capsule of the lens.
4. Finally, he closes the incision with sutures and administers a topical antibiotic to the eye and applies an eye pressure patch.

4. Qualifying circumstances

Patients eligible to undergo CPT 66820 are those with a secondary membranous cataract, characterized by a cloudy and thickened capsule, typically affecting individuals who have recently undergone cataract surgery. The procedure is performed by a provider using a stab incision technique with a needle or Ziegler or Wheeler knife.

5. When to use CPT code 66820

CPT code 66820 should be used when a provider performs the discission procedure for a secondary membranous cataract using a stab incision technique. It is important to note that this code should not be used when a laser, such as a YAG laser, is used instead of a knife. In such cases, CPT code 66821 should be used.

6. Documentation requirements

To support a claim for CPT 66820, the provider must document the following information:

• Patient’s diagnosis of secondary membranous cataract
• Details of the stab incision technique used, including the specific instrument (needle, Ziegler or Wheeler knife)
• Date of the procedure
• Incision site and size
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 66820, ensure that the procedure is performed using a stab incision technique with a needle or Ziegler or Wheeler knife. It is important to note that CPT code 66820 should not be reported with other codes, such as CPT codes 66821. Additionally, consider the location of the testing, as it may impact how the procedure is coded.

8. Historical information

CPT 66820 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 performing a discission procedure using a stab incision technique with a Ziegler knife for a patient with a secondary membranous cataract.
2. A surgeon making an incision in the posterior capsule using a needle to remove the opacity from the capsule of the lens for a patient with a secondary membranous cataract.
3. A provider using a Wheeler knife to create a hole in the posterior capsule and break the cataract into smaller pieces for a patient with a secondary membranous cataract.
4. A surgeon closing the incision with sutures and applying an eye pressure patch after performing a discission procedure using a stab incision technique for a patient with a secondary membranous cataract.
5. A provider administering a topical antibiotic to the eye following a discission procedure using a stab incision technique with a needle for a patient with a secondary membranous cataract.
6. A surgeon using an ocular speculum to open the eye and dilating the pupil before performing a discission procedure for a patient with a secondary membranous cataract.
7. A provider instilling a medication into the eye to dilate the pupil prior to making an incision in the posterior capsule using a Ziegler knife for a patient with a secondary membranous cataract.
8. A surgeon removing the haziness from the capsule of the eye using a small needle for a patient with a secondary membranous cataract.
9. A provider performing a discission procedure using a stab incision technique with a Wheeler knife to remove the opacity from the capsule of the lens for a patient with a secondary membranous cataract.
10. A surgeon documenting the details of a discission procedure performed using a stab incision technique with a needle for a patient with a secondary membranous cataract.