How To Use CPT Code 67031

CPT 67031 describes a procedure involving the use of a laser to remove vitreous material that is obstructing a patient’s vision. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 67031?

CPT 67031 can be used to describe a procedure in which a laser is utilized to remove vitreous material that is causing vision obstruction in a patient. This code is used when the provider uses a YAG laser to destroy protein and detached vitreous matter in the eye, improving the patient’s vision. The procedure involves the provider dilating and examining the eye, applying a topical anesthetic, and using a special contact lens on the patient’s cornea. The provider then uses the YAG laser to destroy the obstructing vitreous material, being careful to avoid the lens and retina. Multiple treatment sessions may be necessary in some cases.

2. Official Description

The official description of CPT code 67031 is: ‘Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages).’ This code specifically refers to the use of a laser to remove vitreous material that is obstructing the patient’s vision.

3. Procedure

1. The provider begins by fully dilating and examining the patient’s eye.
2. A topical anesthetic is applied to ensure the patient’s comfort during the procedure.
3. A special contact lens is placed on the patient’s cornea to facilitate the laser treatment.
4. Using a YAG laser, the provider starts the treatment anteriorly and proceeds inwards, carefully avoiding the lens and retina.
5. The provider uses the laser to destroy protein and detached vitreous matter that is obstructing the patient’s vision.
6. Multiple treatment sessions may be necessary to fully remove the obstructing vitreous material.

4. Qualifying circumstances

CPT 67031 is performed on patients who have vitreous material obstructing their vision. This can include vitreous strands, adhesions, sheets, membranes, or opacities. The procedure is typically performed by an ophthalmologist or other qualified eye care professional. It is important to note that CPT 67031 is bundled with vitrectomy procedures, so it should not be reported separately if vitrectomy codes are already used.

5. When to use CPT code 67031

CPT code 67031 should be used when a provider performs a laser surgery to remove vitreous material that is obstructing a patient’s vision. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure involves other vitreous-related interventions, such as vitrectomy, it is important to use the appropriate bundled code instead of reporting CPT 67031 separately.

6. Documentation requirements

To support a claim for CPT 67031, the provider must document the following information:

• Patient’s diagnosis and the need for the procedure
• Details of the laser surgery, including the use of a YAG laser
• Date of the procedure
• Start and end time of the procedure
• Specific vitreous material targeted and removed
• Any complications or additional treatment sessions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 67031, ensure that the procedure meets the criteria outlined in the code description. It is important to note that CPT 67031 is bundled with vitrectomy procedures, so it should not be reported separately if vitrectomy codes are already used. It is also important to follow any specific guidelines provided by payers regarding the use of this code.

8. Historical information

CPT 67031 was added to the Current Procedural Terminology system on January 1, 1990. The code description was updated on January 1, 2009 to clarify the specific procedures included in the code.

9. Examples

1. A patient undergoes CPT 67031 to remove vitreous strands that are obstructing their vision.
2. A provider performs CPT 67031 to remove vitreous face adhesions that are causing vision impairment in a patient.
3. CPT 67031 is used to remove sheets of vitreous material that are obstructing a patient’s vision.