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The ciliary body is an essential structure located just behind the iris of the eye. It plays a crucial role in two primary functions: the production of aqueous humor, which is the clear fluid filling the anterior chamber of the eye, and accommodation, which is the process that alters the shape of the crystalline lens to enable the eye to focus on objects at varying distances. The procedure described by CPT® Code 66740, known as ciliary body destruction via cyclodialysis, is specifically performed to address cases of glaucoma that have not adequately responded to medication or other less invasive surgical interventions. During this procedure, a local periocular anesthetic is administered to ensure patient comfort. A lid speculum is then utilized to keep the eyelids open, allowing the surgeon to access the eye. The technique of cyclodialysis involves the separation of the ciliary body from the scleral spur, which facilitates the creation of a communication pathway between the anterior chamber and the suprachoroidal space. This newly established connection enables the aqueous humor to flow out of the anterior chamber, thereby effectively reducing intraocular pressure, which is a critical factor in managing glaucoma.
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The procedure of ciliary body destruction via cyclodialysis is indicated for specific conditions related to glaucoma. The following are the primary indications for performing this procedure:
The procedure of ciliary body destruction through cyclodialysis involves several critical steps that are performed with precision to ensure effectiveness and patient safety. The following outlines the procedural steps:
After the completion of the cyclodialysis procedure, patients typically require monitoring to assess the effectiveness of the treatment and to ensure there are no immediate complications. Post-procedure care may include the use of topical medications to manage inflammation and prevent infection. Patients are often advised to avoid strenuous activities and to follow up with their ophthalmologist for ongoing evaluation of intraocular pressure and overall eye health. Recovery times can vary, but patients should be informed about the signs of potential complications, such as increased pain or vision changes, that would necessitate prompt medical attention.
| Short Descr | DESTRUCTION CILIARY BODY | Medium Descr | CILIARY BODY DESTRUCTION CYCLODIALYSIS | Long Descr | Ciliary body destruction; cyclodialysis | 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 | 14 - Glaucoma procedures |
| 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). | 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). | 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. | 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) | 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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| 2017-01-01 | Changed | Medium description changed. |
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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