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The procedure described by CPT® Code 67218 involves the destruction of localized lesions in the retina, which may include conditions such as macular edema or tumors. This treatment utilizes radiation through the implantation of a radioactive source, which is a method often referred to as plaque radiotherapy or plaque brachytherapy. The procedure is specifically designed to target localized lesions within the eye, including the choroid, retina, or iris, with a focus on tumors like melanoma. The radioactive implant consists of a custom-made, sealed metal plaque that contains small radioactive seeds. These seeds are engineered to deliver a precise dose of radiation to the affected area over a specified duration, typically ranging from 4 to 7 days. Following this treatment period, the radioactive source is removed. The procedure begins with an incision in the conjunctiva, allowing the plaque to be positioned accurately over the lesion and secured to the sclera with sutures. After the plaque is in place, the conjunctiva is sutured closed, and the eye is protected with a lead shield to minimize radiation exposure to surrounding tissues. Upon completion of the treatment, the conjunctiva is incised again to remove the plaque, and the conjunctiva is sutured closed once more, ensuring proper healing and protection of the eye.
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The procedure associated with CPT® Code 67218 is indicated for the treatment of specific localized lesions within the eye. These indications include:
The procedure for CPT® Code 67218 involves several critical steps to ensure the effective delivery of radiation to the targeted lesion. These steps include:
Post-procedure care for patients undergoing the treatment associated with CPT® Code 67218 includes monitoring for any signs of complications, such as infection or excessive inflammation. Patients may be advised to avoid strenuous activities and to follow up with their healthcare provider for regular assessments of their eye health. It is essential to ensure that the eye heals properly after the removal of the radioactive plaque, and any prescribed medications, such as anti-inflammatory or antibiotic eye drops, should be used as directed to promote recovery.
| Short Descr | TREATMENT OF RETINAL LESION | Medium Descr | DSTRJ LESION RETINA 1/> SESS RADJ IMPLTJ | Long Descr | Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) | 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) | P4D - Eye procedure - treatment of retinal lesions | MUE | 1 | CCS Clinical Classification | 17 - Destruction of lesion of retina and choroid |
| 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) | GC | This service has been performed in part by a resident under the direction of a teaching physician | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 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.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). |
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| 2009-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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