How To Use CPT Code 66940

CPT 66940 describes the procedure for the removal of lens material from the eye while leaving the elastic capsule intact for the implantation of an intraocular lens. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 66940?

CPT 66940 can be used to describe the surgical procedure in which the provider removes the natural lens of the eye while preserving the elastic capsule that allows for the placement of an intraocular lens. This code is used when the lens material is extracted using an extracapsular approach, excluding other specific codes for lens removal.

2. Official Description

The official description of CPT code 66940 is: ‘Removal of lens material; extracapsular (other than 66840, 66850, 66852).’ This code should be used when the provider removes the hard nucleus and soft cortex of the lens, while leaving the posterior shell of the capsule intact to support the placement of an intraocular lens.

3. Procedure

1. The provider prepares the patient for the procedure, ensuring appropriate anesthesia and prepping the eye.
2. An incision is made in the cornea at the junction of the sclera and cornea.
3. The provider opens the lens capsule and removes the hard nucleus of the lens.
4. The soft cortex of the lens is suctioned out.
5. The posterior shell of the capsule is left in place to strengthen and support the placement of an intraocular lens.
6. The incision is closed with sutures, typically 2-3, and the anterior chamber is injected with saline solution to restore intraocular pressure.
7. Medications, such as steroids and antibiotics, are placed in the operated eye, and a bandage is applied.

4. Qualifying circumstances

CPT 66940 is performed on patients who require the removal of lens material while preserving the elastic capsule for the implantation of an intraocular lens. This procedure is typically performed on patients with conditions such as cataracts. It is important to note that this code should not be used for the removal of intralenticular foreign bodies without lens extraction, which has a separate code (65235).

5. When to use CPT code 66940

CPT code 66940 should be used when the provider performs the extracapsular removal of lens material, leaving the posterior shell of the capsule intact for the placement of an intraocular lens. It is important to ensure that the procedure meets the specific criteria outlined in the code description to accurately report CPT 66940.

6. Documentation requirements

To support a claim for CPT 66940, the provider must document the following information:

• Patient’s diagnosis necessitating the removal of lens material
• Details of the procedure, including the incision site and technique
• Confirmation of the removal of the hard nucleus and soft cortex of the lens
• Documentation of the preservation of the posterior shell of the capsule
• Number of sutures used to close the incision
• Injection of saline solution into the anterior chamber
• Medications administered and any post-operative instructions

7. Billing guidelines

When billing for CPT 66940, ensure that the procedure meets the criteria outlined in the code description. It is important to note that CPT 66940 should not be reported if other specific lens removal codes (66840, 66850, 66852) are performed. Additionally, consider the use of modifiers when appropriate to indicate specific circumstances or additional services provided during the procedure.

8. Historical information

CPT 66940 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 cataracts undergoes CPT 66940 to have the lens material removed and an intraocular lens implanted.
2. A provider performs CPT 66940 on a patient with a traumatic injury to the eye, requiring the removal of lens material and preservation of the posterior shell of the capsule.
3. An elderly patient with age-related cataracts undergoes CPT 66940 to improve their vision and quality of life.
4. A provider performs CPT 66940 on a patient with a history of lens dislocation, requiring the removal of lens material and placement of an intraocular lens.
5. A patient with a congenital lens abnormality undergoes CPT 66940 to correct their vision and improve their overall eye health.
6. A provider performs CPT 66940 on a patient with a history of chronic inflammation in the eye, requiring the removal of lens material and preservation of the posterior shell of the capsule.
7. An individual with a significant refractive error undergoes CPT 66940 to have the lens material removed and an intraocular lens implanted for improved vision.
8. A patient with a history of lens opacities undergoes CPT 66940 to restore their vision and enhance their daily activities.
9. A provider performs CPT 66940 on a patient with a history of lens subluxation, requiring the removal of lens material and preservation of the posterior shell of the capsule.
10. An elderly patient with significant visual impairment due to cataracts undergoes CPT 66940 to improve their quality of life and independence.