Use of 67113

GRANNAN

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67113 is complex retinal detachment repair.
my question is must the patient have all the conditions listed: proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity and a retinal tear of greater than 90 degrees, to be able to use this code?
or is it based on the procedures performed?

the patient I'm coding has the proliferative diabetic retinopathy and traction retinal detachment. surgeon did a vitrectomy, membrane peel & endolaser photocoagulation.

any help is appreciated.

thank you
 

leren44

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what's the approach?

if the approach is pars plana, then consider looking at cpt 67042. The retinal doctors in the facility I work for do a lot of ppv's for traction detachments and proliferative retinopathy. Again, if the approach is pars plana, then I would code 67042.

For the use of 67113, no, all conditions listed are not required. Those are examples of conditions in which this code is appropriate. Again, I would look closely at the approach. If the vitrectomy was done pars plana I would use 67042. If not, 67113 would be appropriate.
 

GRANNAN

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thanks for the info. I will take another look at the OP and look again at both codes
 
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