How To Use CPT Code 66850

CPT 66850 describes the procedure for the removal of lens material using phacofragmentation technique, either mechanical or ultrasonic, with aspiration. 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 66850?

CPT 66850 is used to describe the surgical procedure for the removal of lens material from the eye. This procedure utilizes phacofragmentation technique, which can be either mechanical or ultrasonic, along with aspiration. The purpose of this procedure is to treat cataracts, which cause blurred vision by obscuring the patient’s vision.

2. Official Description

The official description of CPT code 66850 is: ‘Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration.’

3. Procedure

1. The provider begins by making an incision at the border of the sclera and cornea, after the patient has been appropriately prepped and anesthetized.
2. A probe connected to a needle that vibrates at a high speed is inserted into the eye. This probe produces ultrasonic waves that break down the lens material.
3. An aspiration machine is connected to the probe, which continuously irrigates the eye and helps to remove smaller lens fragments.
4. Throughout the procedure, the provider carefully aspirates the lens material.
5. Once the lens material has been successfully removed, the provider closes the incision with sutures.
6. The provider restores the intraocular pressure, administers a topical antibiotic to the eye, and applies an eye pressure patch.

4. Qualifying circumstances

CPT 66850 is performed on patients with cataracts, a condition in which the lens of the eye becomes opaque, causing blurred vision. The procedure is typically performed by an ophthalmologist or an eye surgeon. It is important to note that this code specifically refers to the phacofragmentation technique, either mechanical or ultrasonic, with aspiration.

5. When to use CPT code 66850

CPT code 66850 should be used when the provider performs the removal of lens material using phacofragmentation technique, either mechanical or ultrasonic, with aspiration. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 66850, the provider must document the following information:

• Patient’s diagnosis of cataracts
• Details of the phacofragmentation technique used (mechanical or ultrasonic)
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 66850, it is important to ensure that the procedure meets the specific criteria outlined in the code description. Additionally, consider the following guidelines:

• Do not report CPT 66850 if the lens material is not far from its original position and only a partial posterior vitrectomy is necessary to remove it. In such cases, report CPT 66852 instead.
• Be aware that CPT 66850 is part of the range of Removal of Lens Material Procedures of the Eye, which includes codes 66830-66940.

8. Historical information

CPT 66850 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. An ophthalmologist performing phacofragmentation with aspiration to remove lens material from a patient with cataracts.
2. A surgeon utilizing ultrasonic phacofragmentation technique with aspiration to remove lens material from a patient with advanced cataracts.
3. A provider performing mechanical phacofragmentation with aspiration to remove lens material from a patient with complicated cataracts.
4. An ophthalmologist using phacofragmentation technique with aspiration to remove lens material from a patient with cataracts and an anterior segment intraocular foreign body.
5. A surgeon performing phacofragmentation with aspiration and vitrectomy to remove lens material from a patient with cataracts and a posterior segment intraocular foreign body.
6. An ophthalmologist utilizing mechanical phacofragmentation technique with aspiration to remove lens material from a patient with cataracts and an endocapsular ring.
7. A provider performing ultrasonic phacofragmentation with aspiration and anterior segment intraocular foreign body removal to remove lens material from a patient with complicated cataracts.
8. A surgeon using phacofragmentation technique with aspiration and vitrectomy to remove lens material from a patient with advanced cataracts and an endocapsular ring.
9. An ophthalmologist performing mechanical phacofragmentation with aspiration and anterior segment intraocular foreign body removal to remove lens material from a patient with complicated cataracts and an endocapsular ring.
10. A provider utilizing ultrasonic phacofragmentation technique with aspiration and vitrectomy to remove lens material from a patient with advanced cataracts and an anterior segment intraocular foreign body.