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Help with vitrectomy

  1. #1
    Question Help with vitrectomy
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    Please any suggestions would be appreciated. Docs office used 67036 for vitrectomy I was questioning the anterior chamber - can that be coded seperately. Pt also had trabeculectomy.

    The anterior chamber was rather full of vitreus which could be seen freely moving around. Also, the anterior capsule was opened in a way that did not appear to be consistent with a simple YAG capsulotomy. Most of the capsule was in the infeior portion of the pupil and I could not identify the superior edge of the opened capsule. It appeard most of the capsule was down below.

    An MVR blade was used to enter the eye through the marked area for the posterior vitrectomy. Then a side port incision of the cornea was used for irrigation. The vitrector was placed through the pars plana into the vitreus and the tip was seen just behind the implant. The anterior chamber port was used for the irrigation with the instrument for the vitrectomy. In other words, the anterior chamber was where the fluid came in and the vitrector was then behind the implant through the pars plana. The vietrectomy was then performed for a few minutes unitl some movement was seen of the vitreus in the anterior chamber to some degree. I was not sure it was all removed. The vitrector was removed and some vitreus was coming out of the sclerostomy, which was cut with the vitrectomy unit. The anterior chamber was then visualized and vitreus was still seen in the anterior chamber. Therefore, the MVR blade was used to make an incision into the anterior chamber under the superficial scleral flap which had been developed just before the vitrectomy was started. This was placed in the area where the sclerostomy was later to be made. This gave access to the anterior chamber where the vitretor was placed in the anterior chamber and all of the visible viterus was removed from the anterior chamber through this fashion. On removing the instrument there still was some vitreus coming over the superior edge of the implant. The vitrector was then placed back into the posterior segment through the paras plana approach. More vitrectomy was performed and then more was required anteriorly as well. This was repeated a total of three times both anterior and posterior before all vitreus was cleared from the anterior chamber.



  2. Thumbs up
    Posterior (Pars plana) and anterior both vitrectomy procedures were performed in this case. 67036 includes anterior vitrectomy procedures as per CCI edits, so only 67036 should be coded.

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