cpt 66991, cpt code 66991, 66991 cpt code

CPT Code 66991 | Description, Procedure & Billing Guidelines (2022)

Report CPT code 66991 for extracapsular cataract removal with insertion of an intraocular lens prosthesis with (an) drainage device(s).

1. What Is CPT Code 66991?

CPT 66991 covers a procedure in which an intraocular lens prosthesis is inserted during an extracapsular cataract extraction procedure.

To lower pressure in the eye, the provider can also insert (an) anterior segment aqueous drainage devices(s).

2. Description

The CPT book describes 66991 as follows: “Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification); with insertion of intraocular (e.g., trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more.”

3. Procedure

The 66991 procedure begins with local anesthesia to the patient’s eye. Then, the provider incisions the eye and remove the hard nucleus from the lens. They leave the capsule partially intact by evacuating the soft lens cortex only.

The provider might use a magnification tool to improve their vision and continues the procedure by inserting a prosthetic intraocular lens with the I&A technique (irrigation & aspiration).

Then, they might use an ultrasonic device to break up the cloudy lens (also called: phacoemulsification) and use the ‘irrigation and aspiration’ technique to remove the broken lens from the patient’s eye.

Next, the provider inserts the intraocular lens prosthesis and uses a drainage device. This device is placed in the trabecular meshwork. They might place more than one draining device if necessary.

Especially patients with glaucoma need to reduce pressure from their eye with drainage devices during the 66991 CPT code procedure.

Finally, the provider places an antibiotic solution into the patient’s eye after closing the surgical wounds.

4. How To Use CPT Code 66991

Be aware that there is a difference between extracapsular and intracapsular extraction. Intracapsular extraction aims to remove both the capsule and the lens, while only the lens is removed during an extracapsular procedure.

Use CPT 66991 with CPT 0671T for inserting intraocular anterior segment drainage devices into the patient’s trabecular meshwork if the procedure was performed without concomitant cataract removal and with an intraocular lens implant.

Report CPT code 66984 if the provider did not use a concomitant aqueous drainage device for extracapsular cataract removal with an intraocular lens implant.

5. Resources

CPT Professional 2022

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56866&ver=12&Date=&DocID=A56866&SearchType=Advanced&bc=JAAAABAAEAAA&=

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