How To Use CPT Code 66982

CPT 66982 involves complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using specialized devices or techniques. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 66982.

1. What is CPT 66982?

CPT 66982 is a medical procedure code used to describe complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis. This procedure involves the use of specialized devices or techniques not typically used in routine cataract surgery, such as an iris expansion device, suture support for the intraocular lens, or primary posterior capsulorrhexis.

2. 66982 CPT code description

The official description of CPT code 66982 is: “Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation.”

3. Procedure

The 66982 procedure involves the following steps:

1. Preparation and anesthesia: The patient is prepped and anesthetized, typically with local anesthesia applied to the eye.
2. Incision: The provider makes a small incision in the eye.
3. Extracapsular cataract removal: The provider enters the capsule and removes the hard nucleus from the lens of the eye. An iris expansion device may be used to achieve stable dilation of the pupil.
4. Evacuation of soft lens cortex: The provider evacuates the soft lens cortex, leaving the capsule partially intact. A microscope is used for visualization.
5. Irrigation and aspiration (I&A) or phacoemulsification: The provider uses I&A to remove the cloudy lens from the eye or employs phacoemulsification, an ultrasonic device that breaks up the cloudy lens before I&A.
6. Insertion of intraocular lens prosthesis: The provider inserts the prosthetic intraocular lens.
7. Suturing and antibiotic solution: The provider sutures the incision and places an antibiotic solution into the eye.

4. Qualifying circumstances

Patients eligible to receive CPT code 66982 services are those who require complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis. This procedure is indicated for patients with specific conditions or complications that necessitate the use of specialized devices or techniques not typically used in routine cataract surgery. Examples of such conditions include patients in the amblyogenic developmental stage or those requiring an iris expansion device, suture support for the intraocular lens, or primary posterior capsulorrhexis.

5. When to use CPT code 66982

It is appropriate to bill the 66982 CPT code when a provider performs a complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using specialized devices or techniques not generally used in routine cataract surgery. This code should be used for patients with specific conditions or complications that require these advanced techniques.

6. Documentation requirements

To support a claim for CPT 66982, the following information should be documented:

• Patient’s medical history and diagnosis
• Indications for the complex extracapsular cataract removal procedure
• Details of the specialized devices or techniques used during the procedure
• Step-by-step description of the procedure performed
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 66982, it is essential to ensure that the procedure meets the criteria for complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using specialized devices or techniques. Additionally, proper documentation must be maintained to support the claim. It is also important to be aware of any payer-specific guidelines or requirements related to billing for this code.

8. Historical information

CPT 66982 was added to the Current Procedural Terminology system on January 1, 2001. There have been several updates to the code since its introduction, with the most recent change occurring on January 1, 2020.

9. Similar codes to CPT 66982

Five similar codes to CPT 66982 include:

• CPT 66984: Standard extracapsular cataract removal with intraocular lens prosthesis insertion
• CPT 66987: Complex extracapsular cataract removal with intraocular lens prosthesis insertion and concomitant endoscopic cyclophotocoagulation
• CPT 66989: Complex extracapsular cataract removal with intraocular lens prosthesis insertion and concomitant intraocular aqueous drainage device by internal approach
• CPT 0308T: Insertion of ocular telescope prosthesis, including removal of crystalline lens
• CPT 66840: Removal of lens material, pars plana approach

10. Examples

Here are 10 detailed examples of CPT code 66982 procedures:

1. A 60-year-old patient with a dense cataract and a history of pseudoexfoliation syndrome undergoes complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using an iris expansion device.
2. A pediatric patient in the amblyogenic developmental stage requires complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis and primary posterior capsulorrhexis.
3. A patient with a history of ocular trauma undergoes complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using suture support due to insufficient capsule support.
4. A patient with a history of uveitis and complicated cataract undergoes complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using an iris expansion device and primary posterior capsulorrhexis.
5. A patient with a history of glaucoma and cataract undergoes complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using phacoemulsification and an iris expansion device.
6. A patient with a history of previous vitrectomy and cataract undergoes complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using suture support for the intraocular lens.
7. A patient with a history of retinal detachment and cataract undergoes complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using an iris expansion device and suture support for the intraocular lens.
8. A patient with a history of corneal transplant and cataract undergoes complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using phacoemulsification and primary posterior capsulorrhexis.
9. A patient with a history of ocular inflammation and cataract undergoes complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using an iris expansion device and suture support for the intraocular lens.
10. A patient with a history of previous radial keratotomy and cataract undergoes complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using phacoemulsification and an iris expansion device.