Ophthalmology and Optometry Coding Alert

Retinal Repairs:

67108 or 67112? Don't Let Confusion Derail Your Coding for Recurrent Retinal Repairs

Knowing the difference can mean $262 to your practice.Two retinal repair codes top coders' charts as the most difficult to use: 67108 (Repair of retinal detachment; with vitrectomy, any method, with or without air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique) and 67112 (... by scleral buckling or vitrectomy, on patient having previous ipsilateral retinal detachment repair[s] using scleral buckling or vitrectomy techniques).The confusion surrounding CPT codes 67108 and 67112 is attributable to the similarity in the language used in their descriptors and the failure of CPT to instruct coders onwhich code should be used for recurrent repairs. As a general rule, coders think of CPT code 67108 as representing an initial retinal detachment repair procedure and 67112 as representing subsequent retinal detachment repairs. But this rule of thumb does not always apply, and that's a good [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.