Ophthalmology and Optometry Coding Alert

The "You Be the Coder" challenge in Ophthalmology Coding Alert Volume 12, Number 1, recommended reporting code 65435 (Removal of corneal epithelium; with or without chemocauterization [abrasion, curettage]) for rust ring removal using a slit lamp and a burr. But that code may not accurately describe the work being done, explains David K. Emmel, MD, an ophthalmologist in Wethersfield, Conn. "I have been removing corneal rust rings for 25 years and I can tell you that apart from the occasional accident, I have never removed corneal epithelium to do this," Emmel says. "The rust is embedded in the Bowman's membrane and often in the underlying stroma, but is never in the epithelium; in fact, there is virtually always an epithelial defect overlying the rust ring." The procedure: Emmel removes rust rings with a hypodermic needle that cuts under and around the rust to loosen it so he [...]