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Thread: Please help/ 66982 Question

  1. #1

    Default Please help/ 66982 Question

    AAPC: Back to School
    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.

  2. #2

    Default complicated cataract

    I would say no, it is just a dye, correct?

  3. #3


    see www.ngsmedicare.com website - the cataract policy has some good info

  4. #4
    Join Date
    Apr 2007


    Trypan blue or indocyanine green (ICG) does qualify as complex - unless performed routinely, such as when teaching residents. There is a very informative article by Riva Lee Asbell @ eyeworld.org

  5. #5


    Thanks for the response, I was able to find the article from Eyeworld, very informative. Thanks again for responding

  6. #6
    Join Date
    Apr 2007
    Bangor, Maine


    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

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