CPT code 66984 is used to report for services when extracapsular cataract removal surgery is performed by the surgeon using the manual or mechanical technique to insert an artificial lens without endoscopic cyclophotocoagulation.
CPT Code 66984 Description
The patient with cataracts usually has poor visibility, diplopia, cloudy or blurry vision, enhanced nearsightedness, and distortion of vision.
The physician removes the nucleus of the lens capsule and the anterior shell and leaves the posterior shell of the lens capsule in place in extracapsular cataract extraction (ECCE).
The physician creates incisions in the corneal-scleral juncture (the limbus) by incorporating a lid speculum between the patient’s eyelids. To increase fluid flow in the eye, the physician may create an artificial opening in the iris.
The physician removes the lens in layers such as the anterior lens, then the inner, hard nucleus except for the clear, posterior capsule. To protect the cornea, the air bubble is administered by injection into the anterior chamber using a cutting and suction or ultrasonic device.
The physician aids in identifying the suitable place for an intraocular implant into the eye. To implant the lens in the correct or original cataract position, computer technology is used called haptics placed into the ciliary sulcus or the lens capsule.
The suture may be applied to close the incision and restore the intraocular pressure by administering the injection. The antibiotic patch or pressure may be applied to prevent infection.
CPT 66984 will be reported for service when extracapsular cataract removal surgery is performed by the surgeon with the incorporation of intraocular lens prosthesis (1 stage procedure), mechanical technique, or manual (e.g., aspiration or phacoemulsification and irrigation) without endoscopic cyclophotocoagulation
CPT Code 66984 Reimbursement
A maximum of 1 unit of CPT 66984 can be billed on the same date of service, while two units can be billed when documentation supports the medical necessity of CPT 66984.
When performed in the facility, the cost, and RUVS of CPT 66984 will be $599.62 and 17.32697, respectively. At the same time, non-facility will be $599.62 and 17.32697, respectively.
66984 CPT Code Modifiers
The following is the list of modifiers relevant to CPT 66984:
- 22, 23, 47, 50, 51, 52, 53, 54, 55, 56, 58, 59, 63, 73, 74, 76, 77, 78, 79, 99, AI, AQ, AR, CC, CR, EY, ET, Q5, Q6, QJ, SG, XE, XU, XP, XE, XS, GA, GC, GJ, GK, GR, GU, GY, GZ, KX, LT, RT and PT.
Modifier 50 will apply to CPT 66984 extracapsular cataract-removal surgery performed bilaterally.
For instance, the patient had extracapsular cataract removal surgery on both left and right eye, and then it would be reported like 66984 -50, H26.213.
Modifier LT or RT will be appended with CPT code 66984 if unilateral cataract surgery removal is performed. For example, the patient had extracapsular cataract-removal surgery on the right eye.
It would be reported as 66984-RT. Some insurance accepts this service as two lines, like 66984-RT and 66984, instead of billing as 1 line with modifier 50 such as 66984-50.
Check the appropriate insurance or third-party payer guidelines and bill accordingly.
CPT 66984 has 90 days (about three months) global period, and it would start one day before the surgery, day of surgery, and post-operative.
If only one physician is provided all preoperative, surgery, and post-operative services, then there is no modifier requirement for this CPT 66984.
If an ophthalmologist shares post-operative and preoperative care with another physician, then modifier 54 (surgical only) will be applicable with CPT 66984.
Modifier 23 is applicable with CPT code 66984 if general or local anesthesia is given to patients who are normally not required for the procedure.
Modifier 76 will be attached to CPT code 66984 if service is repeated by the same physician on the same date of service, while modifier 77 if the procedure has been done on the same date service by a different physician, respectively.
Modifier 78 will be appended with CPT code 66984 if the procedure is repeated with the same condition of the global period. In contrast, modifier 79 is applicable when the procedure is reported for an unrelated condition.
Modifier 59 is applicable with CPT code 66984. If any other procedure is done in combination with these services that are not normally billed together on the same date of service, then modifier 59 will be appropriate.
While modifier 51 is applicable when the other procedure is not the component of CPT 66984.
Modifier 53 will be reported with CPT code 66984 if extracapsular cataract removal surgery is terminated due to unavoidable circumstances or unstable patient conditions.
In contrast, modifier 52 is applicable when extracapsular cataract removal surgery is performed with full preparation but needs to terminate the procedure immediately and do not have the plan to redo the procedure in the future.
Then modifier 52 will be appropriate with CPT 66984.
Documentation should support the medical necessity of service and be medically appropriate. The appropriate ICD 10 codes should be reported to the claims for reimbursement.
The most billed dx codes are E10.36, E11.36, H25.011, H25.012, H25.013, H26.211, H26.212, H26.213, H26.221, H26.222, H26.223, etc.
CPT code 66984 includes Lateral canthotomy, Enzymatic zonulysis, Iridectomy/iridotomy, Anterior or posterior capsulotomy, Subtenon injection, Medications Subconjunctival injection, and viscoelastic material.
Therefore, these services will not be reported separately and routinely performed with a retrobulbar injection rather than general anesthesia.
CPT code 66984 has 90 days (about one and a half weeks) global period.
For example, suppose the E/M visit is for post-operative care of the prior surgical procedure. In that case, it is not appropriate to report the E/M code with CPT code 66984 separately during the global period.
While modifier 25 will be applicable with CPT code 66984 if the patient is seen for an unrelated condition on the same procedure date.
If extracapsular cataract-removal surgery (CPT 66984) is performed in combination with Complex extracapsular cataract removal (CPT 66982), then it is appropriate to report 66984 with modifier 59.
If extracapsular cataract-removal surgery (CPT 66984) is performed on the same day with aqueous drainage device insertion CPT code 66989, then it is appropriate to report 66984 with modifier 59.
If extracapsular cataract-removal surgery (CPT 66984) is performed in conjunction with endoscopic cyclophotocoagulation CPT code 66988, it is appropriate to report 66984 with modifier 59.
If extracapsular cataract-removal surgery (CPT 66984) is performed in conjunction with Insertion anterior segment aqueous drainage device only CPT code 0671T, then it appropriate to report 0671T with modifier 59.
Radiologic guidance will be reported with separate CPT codes such as 76519 when performed with extracapsular cataract-removal surgery (CPT 66984).
If extracapsular cataract-removal surgery (CPT 66984) is performed in combination with intraocular lens prosthesis supplied by the physician, it is appropriate to report with separate CPT code 99070.
If extracapsular cataract-removal surgery (CPT 66984) is performed in combination with an ocular telescope prosthesis insertion, then it is appropriate to report with separate CPT code 0308T.
If extracapsular cataract-removal surgery (CPT 66984) is performed in combination with intraoperative visual axis identification, it is appropriate to report with separate CPT code 0514T.
If extracapsular cataract-removal surgery (CPT 66984) is performed in combination with ophthalmic biometry and lens power calculation, then it is appropriate to report with separate CPT code 92136.
Check the payer guideline for supplies used in the procedures for reimbursement and report with appropriate HCPCS level II codes if covered.
CPT 66984 Examples
There are the following examples of CPT 66984 when this service will be billed:
A 56-year-old male presents to the ophthalmologist with blurry vision. He complains that he is unable to see anything. The patient said that visibility is getting poorer day by day.
The patient is restricted to home due to poor visibility. The physician examined both his eyes and saw cloudiness.
The patient also has frequent headaches and denies any other symptoms, numbness, digestive and urinary bladder issue, extremity swelling, dizziness.
The ophthalmologist suggested extracapsular cataract-removal surgery for the patient. The physician had scheduled an appointment for surgery next week.
The surgery was done successfully, and the patient tolerated the procedure very well.
A 70-year-old male presents to the office with a past medical history of chronic kidney disease and now diabetic retinopathy. The patient has had ocular pain for one week, and his normal activities are restricted due to poor eye vision.
The patient also has elevated Diabetes and a higher risk of vision loss. The patient denies any other symptoms like body aches, shortness of breath, numbness, abdominal pain, urinary bladder symptoms.
The physician consulted with an ophthalmologist about his condition. He suggested extracapsular cataract removal surgery to treat the patient’s current condition.
The patient is scheduled for cataracts surgery in the next two weeks.