Ophthalmology and Optometry Coding Alert

Reader Questions:

Let Opacity Location Drive Secondary Cataract Sx Code Choice

Question: When a patient has a secondary membranous cataract following surgery and undergoes reoperation to remove haziness from the capsule, how is the subsequent laser treatment reported?

Colorado Subscriber

Answer: Abnormal proliferation of the cells that remain after cataract surgery may cause opacification of the posterior capsule or anterior capsule. Posterior capsular opacification (PCO) is the most frequent complication of cataract surgery, and the code for PCO laser treatment is 66821 (Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages)). Alternately, use 66999 (Unlisted procedure, anterior segment of eye) to report a laser capsulotomy of the anterior capsule.