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Official Description

Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Prophylaxis of retinal detachment is a critical procedure aimed at preventing the occurrence of retinal detachment, which can lead to severe vision loss if not addressed promptly. This procedure is indicated for patients who exhibit signs of retinal breaks, holes, tears, or lattice degeneration. These conditions can compromise the integrity of the retina, making it susceptible to detachment. The prophylactic management involves the application of either cryotherapy or diathermy techniques to the affected area of the retina. During the procedure, a lid speculum is utilized to keep the eyelids open, allowing for better access to the eye. Local anesthesia is administered to ensure patient comfort throughout the process. The primary goal of this intervention is to create scar tissue around the retinal defect, which helps to secure the retina to the underlying choroid, thereby preventing further complications associated with retinal detachment.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Prophylaxis of retinal detachment is performed for specific indications that include:

  • Retinal Breaks - These are disruptions in the retinal tissue that can lead to detachment if not treated.
  • Retinal Holes - Small openings in the retina that may allow fluid to seep underneath, increasing the risk of detachment.
  • Retinal Tears - These are more severe than holes and can lead to significant retinal detachment if not addressed.
  • Lattice Degeneration - A condition characterized by thinning of the retina, which can predispose individuals to retinal breaks and detachment.

2. Procedure

The procedure for prophylaxis of retinal detachment involves several critical steps:

  • Step 1: Preparation - The patient is positioned comfortably, and a lid speculum is used to hold the eyelids open, providing clear access to the eye. Local anesthetic is administered to minimize discomfort during the procedure.
  • Step 2: Application of Cryotherapy or Diathermy - A freezing probe (cryotherapy) or a heat probe (diathermy) is utilized to treat the retinal defect. In cryotherapy, the probe is applied to the outer surface of the eye through the intact sclera, creating a series of ice balls around the defect area. In diathermy, a radiofrequency current is used to generate heat, which burns the tissue around the defect.
  • Step 3: Lamellar Scleral Dissection - This step involves performing a dissection over the site of the defect to facilitate the application of diathermy burns. A blunt-tipped electrode is used to place burns in the scleral bed, ensuring effective treatment of the defect.
  • Step 4: Healing and Scar Formation - As the treated area heals, scar tissue develops, which serves to close the defect and secure the retina to the choroid, thereby preventing retinal detachment.

3. Post-Procedure

After the procedure, patients may experience some discomfort or temporary vision changes. It is essential to monitor the eye for any signs of complications, such as increased pain, vision loss, or signs of infection. Follow-up appointments are typically scheduled to assess the healing process and ensure that the retina remains securely attached. Patients are advised to avoid strenuous activities and follow any specific post-operative care instructions provided by their healthcare provider to promote optimal recovery.

Short Descr PROPH RTA DTCHMNT CRTX DTHRM
Medium Descr PROPH RETINAL DTCHMNT W/O DRG CRTX DIATHERMY
Long Descr Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy
Status Code Active Code
Global Days 010 - Minor Procedure
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 Procedure or Service, Multiple Reduction Applies
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) P4C - Eye procedure - retinal detachment
MUE 1
CCS Clinical Classification 16 - Repair of retinal tear, detachment
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
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).
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.)
GC This service has been performed in part by a resident under the direction of a teaching physician
SG Ambulatory surgical center (asc) facility service
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2022-01-01 Changed Code description changed.
2009-01-01 Changed Code description changed
Pre-1990 Added Code added.
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