How To Use CPT Code 66987

CPT 66987 describes the complex procedure of extracapsular cataract removal with the insertion of an intraocular lens prosthesis. 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 66987?

CPT 66987 is used to describe a complex procedure involving the removal of a cataract and the insertion of an intraocular lens prosthesis. This code is specifically used when the procedure requires advanced techniques and devices that are not typically used in routine cataract surgery. It may also be performed on patients in the amblyogenic developmental stage, which refers to the early visual development phase where the visual system is at risk of developing abnormal vision.

2. Official Description

The official description of CPT code 66987 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; with endoscopic cyclophotocoagulation.’

3. Procedure

1. The provider begins by making a small incision in the eye and enters the capsule.
2. Using advanced techniques and devices, such as an iris expansion device or suture support for the intraocular lens, the provider removes the hard nucleus from the lens of the eye.
3. The provider then evacuates the soft lens cortex, leaving the capsule partially intact.
4. An ophthalmic viscoelastic device, such as Healon GV, is used to stabilize the anterior chamber and deepen the ciliary sulcus.
5. A laser endoscope is inserted into the eye, allowing the provider to visualize the ciliary body epithelium.
6. The provider uses a laser probe to perform endoscopic cyclophotocoagulation, which shrinks the ciliary processes to treat or prevent glaucoma.
7. A capsulotomy needle or capsulorrhexis forceps is used to create a continuous circular tear in the anterior capsule.
8. The provider completes the capsulorrhexis in a circular manner, allowing the anterior capsule to fold over upon itself.
9. Irrigation and aspiration or phacoemulsification may be used to break up and remove the cloudy lens from the eye.
10. The provider inserts the intraocular lens prosthesis to replace the removed lens.
11. If necessary, the provider may provide suture support for the intraocular lens by suturing it behind the iris.
12. The incision is sutured, and antibiotic and corticosteroid solution is infused into the eye.

4. Qualifying circumstances

CPT 66987 is performed on patients who require complex techniques and devices that are not typically used in routine cataract surgery. This may include the use of an iris expansion device, suture support for the intraocular lens, or primary posterior capsulorrhexis. Additionally, the procedure may be performed on patients in the amblyogenic developmental stage, which refers to the early visual development phase where the visual system is at risk of developing abnormal vision.

5. When to use CPT code 66987

CPT code 66987 should be used when performing a complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis. This code is specifically for procedures that require advanced techniques and devices not typically used in routine cataract surgery. It should not be used for noncomplex extracapsular cataract removal or procedures without endoscopic cyclophotocoagulation.

6. Documentation requirements

To support a claim for CPT code 66987, the provider must document the following information:

• Patient’s diagnosis and the need for complex extracapsular cataract removal
• Specific techniques and devices used during the procedure
• Date of the procedure
• Details of the procedure, including the use of endoscopic cyclophotocoagulation
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 66987, ensure that the procedure meets the criteria for a complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis. It is important to document the use of advanced techniques and devices, as well as the performance of endoscopic cyclophotocoagulation. CPT code 66987 should not be reported with other codes for noncomplex extracapsular cataract removal or procedures without endoscopic cyclophotocoagulation.

8. Historical information

CPT code 66987 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a complex extracapsular cataract removal with the insertion of an intraocular lens prosthesis using an iris expansion device and endoscopic cyclophotocoagulation to treat glaucoma.
2. During a procedure, a provider utilizes suture support for the intraocular lens and performs endoscopic cyclophotocoagulation on a patient in the amblyogenic developmental stage.