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The procedure described by CPT® Code 66160 involves the surgical technique known as fistulization of the sclera, specifically aimed at treating glaucoma. This procedure is characterized by a sclerectomy, which is the surgical removal of a portion of the sclera, the white outer coating of the eyeball, combined with an iridectomy, the surgical removal of a part of the iris. The primary goal of this intervention is to facilitate the drainage of aqueous humor from the eye, thereby reducing intraocular pressure, which is crucial in managing glaucoma. During the procedure, the eye is examined under an operating microscope to ensure precision. An incision is made in the conjunctiva, the thin membrane covering the eye, to access the sclera. The surgeon then carefully incises the sclera near the limbus, the border between the cornea and sclera, and excises a scleral lip using either a punch or scissors. Following this, the iris is manipulated with forceps to create a smooth, inverted flap, which is essential for the iridectomy. This flap allows for improved drainage of fluid from the posterior chamber of the eye, contributing to the reduction of intraocular pressure. Finally, the scleral incision is meticulously closed with sutures, and the conjunctiva is also closed to complete the procedure, ensuring the integrity of the eye structure is maintained.
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The procedure described by CPT® Code 66160 is indicated for the treatment of glaucoma, particularly in cases where other management strategies have failed or are not suitable. The following conditions may warrant the performance of this surgical intervention:
The procedure for CPT® Code 66160 involves several critical steps to ensure effective treatment of glaucoma:
After the completion of the procedure, patients are typically monitored for any immediate complications. Post-operative care may include the use of prescribed medications, such as anti-inflammatory or antibiotic eye drops, to prevent infection and manage inflammation. Patients are advised to avoid strenuous activities and to follow up with their ophthalmologist for regular assessments of intraocular pressure and overall eye health. Recovery time may vary, but patients can generally expect gradual improvement in their condition as the eye heals.
| Short Descr | GLAUCOMA SURGERY | Medium Descr | FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT | Long Descr | Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P4E - Eye procedure - other | MUE | 1 | CCS Clinical Classification | 14 - Glaucoma procedures |
| 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). | 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.) | 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) |
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