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Official Description

Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Multiple punctures of the anterior cornea, as described by CPT® Code 65600, are a specialized ophthalmic procedure aimed at addressing specific conditions affecting the cornea. This procedure is primarily indicated for the treatment of recurrent corneal erosion, a condition where the outer layer of the cornea fails to adhere properly, leading to repeated episodes of pain and visual disturbance. Additionally, it is utilized for cosmetic purposes, particularly in cases of disfiguring corneal scars that may arise from surgical interventions or traumatic injuries. During the procedure, the eye is first numbed with topical anesthetic eye drops to ensure patient comfort. A bent needle, typically ranging from 23 to 25 gauge, is then employed to create multiple small punctures in the anterior stroma of the cornea. These punctures are strategically placed to induce controlled scarring, which promotes healing of the corneal erosion by stimulating the body's natural repair mechanisms. In cases where cosmetic improvement is the goal, an ink stain may be applied to the cornea to assess the aesthetic outcome, allowing for adjustments until the desired appearance is achieved. This procedure is a valuable option for patients suffering from these specific corneal conditions, providing both functional and cosmetic benefits.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Multiple punctures of the anterior cornea are performed for the following indications:

  • Recurrent Corneal Erosion - This condition involves repeated episodes of corneal surface breakdown, leading to pain and visual disturbances.
  • Disfiguring Corneal Scar - This may occur following surgical procedures or trauma, necessitating intervention for cosmetic improvement.

2. Procedure

The procedure for multiple punctures of the anterior cornea involves several key steps that are crucial for its success:

  • Preparation - The patient is positioned comfortably, and topical anesthetic eye drops are instilled to numb the eye, ensuring that the patient experiences minimal discomfort during the procedure.
  • Needle Selection - A bent needle, typically of 23 to 25 gauge, is selected for the procedure. This gauge is appropriate for creating the small punctures needed in the corneal stroma.
  • Puncturing the Cornea - The bent needle is carefully used to make multiple punctures in the anterior stroma of the cornea. These punctures are strategically placed to promote healing by inducing controlled scarring, which aids in the repair of recurrent corneal erosion.
  • Application of Ink Stain - In cases where cosmetic improvement is desired, an ink stain is applied to the cornea. This allows the physician to evaluate the aesthetic outcome and make any necessary adjustments until the desired cosmetic effect is achieved.

3. Post-Procedure

After the procedure, patients may be monitored for any immediate complications. It is common for patients to experience some discomfort or irritation in the treated eye, which can typically be managed with prescribed analgesics or anti-inflammatory medications. Follow-up appointments are essential to assess the healing process and the effectiveness of the treatment. Patients may also be advised on the use of lubricating eye drops to aid in recovery and to prevent dryness. The expected recovery time can vary, but most patients can resume normal activities within a few days, depending on their individual healing response and any specific instructions provided by their healthcare provider.

Short Descr REVISION OF CORNEA
Medium Descr MULTIPLE PUNCTURES ANTERIOR CORNEA
Long Descr Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6C - Minor procedures - other (Medicare fee schedule)
MUE 1
CCS Clinical Classification 19 - Other therapeutic procedures on eyelids, conjunctiva, cornea
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
GA Waiver of liability statement issued as required by payer policy, individual case
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
SG Ambulatory surgical center (asc) facility service
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