How To Use CPT Code 67105

CPT 67105 describes the repair of a detached retina using photocoagulation, including drainage of subretinal fluid if necessary. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 67105?

CPT 67105 can be used to describe the repair of a detached retina using photocoagulation, a procedure that involves using a laser beam to heat up the tissue and seal the torn area of the retina. If there is subretinal fluid present, the provider will also drain it during the procedure. This code is used when the provider performs the repair in one or more sessions.

2. Official Description

The official description of CPT code 67105 is: ‘Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation.’

3. Procedure

1. The provider prepares the patient and administers 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 contact lens is placed on the patient’s eye, and a laser beam is passed through the dilated pupil to seal the torn area of the retina.
5. If there is subretinal fluid present, the provider makes an incision in the sclera to drain the fluid.
6. The incision is closed with sutures, and the intraocular pressure is restored.
7. A topical antibiotic is administered to the eye, and an eye pressure patch is applied.

4. Qualifying circumstances

CPT 67105 is performed on patients with a detached retina that requires repair. The procedure involves photocoagulation and may include drainage of subretinal fluid. The provider must assess the patient’s condition and determine the need for the repair. The patient must be appropriately prepped and anesthetized for the procedure.

5. When to use CPT code 67105

CPT code 67105 should be used when the provider performs the repair of a detached retina using photocoagulation, including drainage of subretinal fluid if necessary. This code is used for each session of the procedure. If the provider starts with photocoagulation but switches to cryotherapy during the procedure, only report the completed procedure and consider appending modifier 22 to indicate the additional work performed.

6. Documentation requirements

To support a claim for CPT 67105, the provider must document the following information:

• Patient’s diagnosis of retinal detachment
• Details of the procedure performed, including photocoagulation and drainage of subretinal fluid if applicable
• Date of the procedure
• Start and end time of the procedure
• Any additional work performed, such as switching to cryotherapy
• Signature of the provider

7. Billing guidelines

When billing for CPT 67105, ensure that the provider performs the repair using photocoagulation and includes drainage of subretinal fluid if necessary. If the provider switches to cryotherapy during the procedure, only report the completed procedure and consider appending modifier 22 to indicate the additional work performed. It is important to follow the guidelines of the payer and provide appropriate documentation to support the claim.

8. Historical information

CPT 67105 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 inclusion of additional procedures.

9. Examples

1. A provider performs photocoagulation and drainage of subretinal fluid during a session to repair a detached retina in a patient.
2. During a retinal detachment repair procedure, the provider uses a laser beam to seal the torn area of the retina and drains subretinal fluid if necessary.
3. A patient undergoes photocoagulation and drainage of subretinal fluid during a session to repair a detached retina.
4. The provider performs a retinal detachment repair using photocoagulation and drains subretinal fluid if necessary.
5. During a procedure to repair a detached retina, the provider uses a laser beam to seal the torn area of the retina and performs drainage of subretinal fluid if required.
6. A patient undergoes photocoagulation and drainage of subretinal fluid during a session to repair a detached retina.
7. The provider performs a retinal detachment repair using photocoagulation and drains subretinal fluid if necessary.
8. During a procedure to repair a detached retina, the provider uses a laser beam to seal the torn area of the retina and performs drainage of subretinal fluid if required.
9. A patient undergoes photocoagulation and drainage of subretinal fluid during a session to repair a detached retina.
10. The provider performs a retinal detachment repair using photocoagulation and drains subretinal fluid if necessary.