bella2
Guru
Hi, just a quick question if the Doctor uses trypan blue in a cataract extraction does it qualify for code 66982 ???
Thanks for all responses.
Thanks for all responses.
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Wiki Please help/ 66982 Question
- Thread starter bella2
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Marge Fuller
Guest
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complicated cataract
I would say no, it is just a dye, correct?
I would say no, it is just a dye, correct?
Jamie Dezenzo
True Blue
see www.ngsmedicare.com website - the cataract policy has some good info
bella2
Guru
Thanks for the response, I was able to find the article from Eyeworld, very informative. Thanks again for responding 
Cheers,
Bella
Cheers,
Bella
Kelly_Josephine
Networker
For any one else interested in this issue here is what I have found most recently - rather definitive - a 2016 AMA update to CPT Assist on the matter:
Here’s the article from CPT Assistant March 2016, page 10
Question: Does the use of Trypan Blue dye to stain dense cataract justify the use of a complicated cataract code 66982, Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage?
Answer: No, the additional work of instilling and removing Trypan Blue dye from the anterior segment though an additional surgical step does not reach the threshold of physician time, work, or intensity necessary to report the complex cataract code. Indications that justify reporting a complex cataract surgery (66982) includes:
1. The presence of a miotic pupil that will not dilate sufficiently to allow operative access to the lens, which requires the insertion of one of the following: four iris retractors through four additional incisions; a Beehler expansion device; a sector iridectomy with subsequent suture repair of; an iris sphincter; or sphincterotomies created with scissors.
2. The presence of a disease state that produces lens support structures that are abnormally weak or absent, which requires the need to support the lens implant with permanent intraocular sutures, or, alternately, a capsular tension ring may be necessary to allow placement of an intraocular lens.
3. Pediatric cataract surgery
Here’s the article from CPT Assistant March 2016, page 10
Question: Does the use of Trypan Blue dye to stain dense cataract justify the use of a complicated cataract code 66982, Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage?
Answer: No, the additional work of instilling and removing Trypan Blue dye from the anterior segment though an additional surgical step does not reach the threshold of physician time, work, or intensity necessary to report the complex cataract code. Indications that justify reporting a complex cataract surgery (66982) includes:
1. The presence of a miotic pupil that will not dilate sufficiently to allow operative access to the lens, which requires the insertion of one of the following: four iris retractors through four additional incisions; a Beehler expansion device; a sector iridectomy with subsequent suture repair of; an iris sphincter; or sphincterotomies created with scissors.
2. The presence of a disease state that produces lens support structures that are abnormally weak or absent, which requires the need to support the lens implant with permanent intraocular sutures, or, alternately, a capsular tension ring may be necessary to allow placement of an intraocular lens.
3. Pediatric cataract surgery
kora09
Guest
Just use trypan blue in a cataract extraction does not qualify for 66982