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The procedure described by CPT® Code 66635 refers to an optical iridectomy, which is a surgical intervention involving the removal of a small, full-thickness section of the iris. This procedure is specifically categorized as a separate procedure and is performed with either a corneoscleral or corneal section. The primary objective of an optical iridectomy is to create an artificial pupil, which is achieved by excising a section of the iris located at the center of the eye. The process begins with the application of a local anesthetic to ensure patient comfort during the procedure. Following anesthesia, a precise incision is made either in the cornea or at the limbus of the sclera, allowing access to the iris. The surgeon utilizes specialized instruments, such as iris forceps or an iris hook, to grasp the edge of the pupil through the incision. Subsequently, iridectomy forceps are employed to draw the iris out through the incision, and iridectomy scissors are used to carefully snip off a small fragment of the iris. This excision is performed in a radial manner, ultimately forming an artificial pupil at the center of the eye, which can improve visual function for patients with specific ocular conditions.
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The optical iridectomy procedure, as described by CPT® Code 66635, is indicated for specific ocular conditions that necessitate the creation of an artificial pupil. The following are the primary indications for performing this procedure:
The procedure for an optical iridectomy involves several critical steps that ensure the successful creation of an artificial pupil. The following outlines the procedural steps:
After the completion of the optical iridectomy, post-procedure care is essential for optimal recovery. Patients are typically monitored for any immediate complications, and instructions regarding eye care are provided. It is common for patients to experience some discomfort or swelling, which can be managed with prescribed medications. Follow-up appointments are necessary to assess healing and ensure that the artificial pupil is functioning as intended. Patients may also be advised on the use of protective eyewear and the importance of avoiding activities that could strain the eye during the initial recovery period.
| Short Descr | REMOVAL OF IRIS | Medium Descr | IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX | Long Descr | Iridectomy, with corneoscleral or corneal section; optical (separate procedure) | 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 | 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 | 20 - Other intraocular therapeutic 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). | 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. | 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.) | 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 | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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