How To Use CPT Code 66991

CPT 66991 describes the procedure of extracapsular cataract removal with the insertion of an intraocular lens prosthesis, along with the insertion of anterior segment aqueous drainage devices. 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 66991?

CPT 66991 can be used to describe a surgical procedure that involves the removal of a cataract and the insertion of an intraocular lens prosthesis. Additionally, this code includes the insertion of anterior segment aqueous drainage devices to lower pressure in the eye. It is important to note that this is a one-stage procedure and can be performed using either a manual or mechanical technique.

2. Official Description

The official description of CPT code 66991 is: ‘Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more.’

3. Procedure

  1. The patient is prepped and anesthetized, typically with local anesthesia applied to the eye.
  2. The provider makes a small incision in the eye and enters the capsule.
  3. The hard nucleus of the lens is removed, and the soft lens cortex is evacuated, leaving the capsule partially intact.
  4. The provider may use techniques such as irrigation and aspiration or phacoemulsification to break up and remove the cloudy lens.
  5. An intraocular lens prosthesis is inserted to replace the removed lens.
  6. The provider inserts one or more anterior segment aqueous drainage devices into the eye to lower pressure, typically in patients with glaucoma.
  7. The surgical wounds are closed, and antibiotic solution is placed into the eye.

4. Qualifying circumstances

CPT 66991 is performed on patients with cataracts, which are characterized by the clouding or opacity of the lens in the eye. The procedure is typically done to improve vision and may involve the insertion of anterior segment aqueous drainage devices to reduce pressure in the eye, especially in patients with glaucoma. It is important to note that this code specifically refers to extracapsular cataract removal with the insertion of an intraocular lens prosthesis and anterior segment aqueous drainage devices.

5. When to use CPT code 66991

CPT code 66991 should be used when a provider performs extracapsular cataract removal with the insertion of an intraocular lens prosthesis and anterior segment aqueous drainage devices in a one-stage procedure. It is important to ensure that the procedure meets the specific criteria outlined in the code description, including the use of a manual or mechanical technique and the absence of an extraocular reservoir.

6. Documentation requirements

To support a claim for CPT 66991, the provider must document the following information:

  • Patient’s diagnosis of cataract
  • Details of the surgical procedure performed, including the technique used (irrigation and aspiration or phacoemulsification)
  • Number of anterior segment aqueous drainage devices inserted
  • Start and end time of the procedure
  • Any additional relevant details or complications
  • Signature of the performing provider

7. Billing guidelines

When billing for CPT 66991, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that this code should not be reported if the procedure does not involve the insertion of anterior segment aqueous drainage devices. Additionally, consider any applicable modifiers or additional codes that may be necessary to accurately report the procedure.

8. Historical information

CPT 66991 was added to the Current Procedural Terminology system on January 1, 2022. There have been no updates or changes to the code since its addition.

9. Examples

  1. A patient undergoes extracapsular cataract removal with the insertion of an intraocular lens prosthesis and anterior segment aqueous drainage devices to manage glaucoma.
  2. A provider performs extracapsular cataract removal with the insertion of an intraocular lens prosthesis and multiple anterior segment aqueous drainage devices in a one-stage procedure.
  3. During a surgical session, a patient undergoes extracapsular cataract removal with the insertion of an intraocular lens prosthesis and an anterior segment aqueous drainage device to lower intraocular pressure.
  4. A provider performs extracapsular cataract removal with the insertion of an intraocular lens prosthesis and an anterior segment aqueous drainage device in a patient with both cataracts and glaucoma.
  5. During a one-stage procedure, a patient undergoes extracapsular cataract removal with the insertion of an intraocular lens prosthesis and multiple anterior segment aqueous drainage devices to manage elevated intraocular pressure.
  6. A provider performs extracapsular cataract removal with the insertion of an intraocular lens prosthesis and an anterior segment aqueous drainage device

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