How To Use CPT Code 67101

CPT 67101 describes the repair of a detached retina using cryotherapy, including drainage of subretinal fluid if necessary. 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 67101?

CPT 67101 can be used to describe the repair of a detached retina using cryotherapy. This procedure involves using extreme cold to freeze the tissue and seal any torn areas in the retina. If there is subretinal fluid present, the provider may also drain it by making an incision in the sclera. The procedure is performed under appropriate anesthesia and requires the use of specialized instruments and equipment.

2. Official Description

The official description of CPT code 67101 is: ‘Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy.’

3. Procedure

1. The provider prepares the patient and administers appropriate anesthesia.
2. An ocular speculum is placed in the patient’s eye to keep it open during the procedure.
3. Using a microscope, the provider identifies any holes or tears in the retina.
4. A cryoprobe, a long, slender surgical instrument that applies extreme cold temperature, is brought in contact with the sclera above the site of retinal detachment.
5. The provider uses the cryoprobe to freeze the tissue, sealing any torn areas in the retina.
6. If there is subretinal fluid present, the provider may make an incision in the sclera to drain the fluid.
7. The provider closes the incision with sutures, restores the intraocular pressure, administers a topical antibiotic to the eye, and applies an eye pressure patch.

4. Qualifying circumstances

CPT 67101 is performed when a patient has a detached retina that requires repair using cryotherapy. The procedure may also involve drainage of subretinal fluid if necessary. The provider must assess the patient’s condition and determine the need for the procedure. The patient must be appropriately prepped and anesthetized for the procedure to be performed safely and effectively.

5. When to use CPT code 67101

CPT code 67101 should be used when a provider performs the repair of a detached retina using cryotherapy, including drainage of subretinal fluid if necessary. It is important to ensure that the procedure is documented accurately and that the medical necessity for the procedure is clearly established.

6. Documentation requirements

To support a claim for CPT 67101, the provider must document the following information:

• Patient’s diagnosis of retinal detachment
• Details of the procedure performed, including the use of cryotherapy and any drainage of subretinal fluid
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 67101, ensure that the procedure meets the criteria for medical necessity and is appropriately documented. It is important to follow the guidelines set forth by the payer and to use the correct coding modifiers, if applicable. It is also important to review any specific billing guidelines provided by the payer to ensure accurate and timely reimbursement.

8. Historical information

CPT 67101 was added to the Current Procedural Terminology system on January 1, 1990. There have been several changes to the code over the years, including updates to the description and the addition of modifiers.

9. Examples

1. A provider performs cryotherapy to repair a detached retina in a patient with subretinal fluid present.
2. A patient undergoes cryotherapy and drainage of subretinal fluid for the repair of a retinal detachment.
3. A provider uses cryotherapy to seal torn areas in the retina and drains subretinal fluid during a retinal detachment repair procedure.
4. A patient with a detached retina undergoes cryotherapy, including drainage of subretinal fluid, to repair the condition.
5. A provider performs cryotherapy and drainage of subretinal fluid to repair a retinal detachment in a patient.
6. A retinal detachment repair procedure is performed using cryotherapy and includes drainage of subretinal fluid.
7. A patient undergoes cryotherapy and drainage of subretinal fluid for the repair of a detached retina.
8. A provider uses cryotherapy to repair a detached retina and performs drainage of subretinal fluid during the procedure.
9. Cryotherapy is performed to repair a retinal detachment, including drainage of subretinal fluid, in a patient.
10. A patient undergoes a retinal detachment repair procedure that includes cryotherapy and drainage of subretinal fluid.