How To Use CPT Code 67115

CPT 67115 describes the release of encircling material in the posterior segment of the eye. 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 67115?

CPT 67115 is used to describe the procedure of adjusting a scleral buckle, which is a device used to repair a retinal detachment. The purpose of the buckle is to push in, or buckle, the sclera towards the retinal tear, holding the retina against the sclera until scarring seals the tear.

2. Official Description

The official description of CPT code 67115 is the release of encircling material (posterior segment). This procedure involves adjusting a scleral buckle, a device used to repair a retinal detachment. The provider places the buckle beneath the scleral band without suturing it and closes the incision using sutures.

3. Procedure

1. The provider begins by placing an ocular speculum in the patient’s eye to hold it open during the procedure.
2. An incision is made in the conjunctiva and sclera to gain access to the buckling device.
3. The provider adjusts the buckle with sutures or places hard silicone pieces of an appropriate size beneath the scleral band.
4. The incision is closed using sutures.

4. Qualifying circumstances

CPT 67115 is performed when a patient has a retinal detachment, which is a medical condition where the retina is separated from its attachment to the supporting layers within the eye. The procedure involves adjusting a scleral buckle to repair the detachment. The patient must be appropriately prepped and anesthetized for the procedure.

5. When to use CPT code 67115

CPT code 67115 should be used when a provider performs the procedure of adjusting a scleral buckle to repair a retinal detachment. It is important to note that this code is specific to the release of encircling material in the posterior segment of the eye.

6. Documentation requirements

To support a claim for CPT 67115, the provider must document the following information:

• Patient’s diagnosis of retinal detachment
• Details of the procedure, including the adjustment of the scleral buckle
• Date of the procedure
• Start and end time of the procedure
• Any additional relevant information or complications
• Provider’s signature

7. Billing guidelines

When billing for CPT 67115, ensure that the procedure involves the release of encircling material in the posterior segment of the eye. It is important to follow the specific guidelines for this code and not report it with other codes unless appropriate. Review the documentation requirements and ensure all necessary information is included in the claim.

8. Historical information

CPT 67115 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider adjusts a scleral buckle to repair a retinal detachment in a patient’s eye.
2. During a surgical procedure, a provider releases encircling material in the posterior segment of the eye to repair a retinal detachment.
3. A patient undergoes a procedure where a scleral buckle is adjusted to treat a retinal detachment.
4. A provider performs the release of encircling material in the posterior segment of the eye to repair a retinal detachment in a patient.
5. During a surgical intervention, a provider adjusts a scleral buckle to address a retinal detachment in a patient’s eye.
6. A patient receives treatment for a retinal detachment through the adjustment of a scleral buckle.
7. A provider performs a procedure to release encircling material in the posterior segment of the eye, specifically to repair a retinal detachment.
8. During a surgical intervention, a provider adjusts a scleral buckle to treat a retinal detachment in a patient.
9. A patient undergoes a procedure where encircling material in the posterior segment of the eye is released to repair a retinal detachment.
10. A provider performs the adjustment of a scleral buckle to address a retinal detachment in a patient’s eye.