How To Use CPT Code 67208

CPT 67208 describes the destruction of a localized lesion of the retina using extreme cold or hot temperatures. 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 67208?

CPT 67208 can be used to describe the destruction of a localized lesion of the retina using either cryotherapy or diathermy. This code is used when a provider applies extreme cold or hot temperatures to the tissue to destroy the lesion. The procedure may involve one or more sessions, depending on the extent of the lesion.

2. Official Description

The official description of CPT code 67208 is: ‘Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider places an ocular speculum in the patient’s eye to hold it open during the procedure.
3. The provider brings a probe in contact with the sclera over the site of the lesion.
4. The provider uses either electric current that heats up the tissue (diathermy) or a cryoprobe that freezes the tissue (cryotherapy) to destroy the lesion.
5. The provider does not move the probe once the tissue adheres to the tip to avoid tearing or breaking the retinal tissue.

4. Qualifying circumstances

CPT 67208 is used for patients with a localized lesion of the retina, such as macular edema or tumors, that requires destruction. The procedure must be performed by a qualified provider and may involve one or more sessions. If the procedure is bilateral, modifier 50 should be added to the code.

5. When to use CPT code 67208

CPT code 67208 should be used when a provider needs to destroy a localized lesion of the retina using cryotherapy or diathermy. It is important to note that this code should not be used if the provider performs the same procedure using photocoagulation or radiation implantation.

6. Documentation requirements

To support a claim for CPT 67208, the provider must document the following information:

• Patient’s diagnosis and the need for lesion destruction
• Specific technique used (cryotherapy or diathermy)
• Date and duration of the procedure
• Details of the procedure, including the use of an ocular speculum and the application of extreme cold or hot temperatures
• Progress made in destroying the lesion and any additional sessions scheduled
• Provider’s signature

7. Billing guidelines

When billing for CPT 67208, ensure that the procedure is performed by a qualified provider and that the appropriate technique (cryotherapy or diathermy) is used. If the procedure is bilateral, modifier 50 should be added to the code. It is important to note that CPT 67208 should not be reported with other codes for the same procedure using different techniques. Additional tips for reporting CPT 67208 may include considerations for the location of the testing and the use of modifiers for facility reporting.

8. Historical information

CPT 67208 was added to the Current Procedural Terminology system on January 1, 1990. The code was later revised on January 1, 2009 to include the specific techniques of cryotherapy and diathermy.

9. Examples

1. A provider using cryotherapy to destroy a macular edema lesion in a patient’s retina.
2. A provider using diathermy to destroy a tumor in a patient’s retina.
3. A provider performing multiple sessions of cryotherapy to completely destroy a localized lesion of the retina.
4. A provider using cryotherapy to destroy a lesion in one eye and diathermy to destroy a lesion in the other eye of the same patient.
5. A provider using cryotherapy to destroy a lesion in a patient’s retina and scheduling additional sessions for further destruction.
6. A provider using diathermy to destroy a lesion in a patient’s retina and documenting the progress made during the procedure.
7. A provider using cryotherapy to destroy a lesion in a patient’s retina and discussing the potential risks and benefits of the procedure with the patient.
8. A provider using diathermy to destroy a lesion in a patient’s retina and providing post-procedure instructions for care and follow-up.
9. A provider using cryotherapy to destroy a lesion in a patient’s retina and documenting the patient’s response to the procedure.
10. A provider using diathermy to destroy a lesion in a patient’s retina and discussing the expected outcomes of the procedure with the patient.