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please help with PHOTOCOAGULATION

  1. #1
    Pensacola , Florida
    Default please help with PHOTOCOAGULATION
    Medical Coding Books
    both eyes were done ... I know one of the codes is 67228 RT/LT
    but I am lost on the second procedure ...because it seems to all fall under 67228 - doc says use 67105 ?

    POSTOPERATIVE DIAGNOSIS: Lattice degeneration retinal breaks and
    peripheral retinal degenerative disease left eye

    PROCEDURE: Laser photocoagulation for lattice degeneration retinal
    breaks and peripheral retinal degenerative disease left eye[/COLOR]

    PROCEDURE IN DETAIL: Intravenous Fentanyl was given as well as
    intravenous Toradol 30 mg. Anesthesiology was present to monitor
    these. Lid speculum was placed after topical anesthesia. Then using
    the Argon Green laser indirect ophthalmoscope 500 micron spot size 0.1
    second exposure time power begun at 100 milliwatts and gradually
    increased until moderate takes at the level of the outer retina and
    pigment epithelium were achieved. I surrounded the areas of lattice
    degeneration inferiorly with three to four rows of semiconfluent laser,
    carried them out to the aura, placed scattered laser peripheral
    retinopexy 360 degrees anterior to the equator and up to the aura and
    then directed our attention to the principal area of concern which is
    superiorly and superotemporally where multiple areas of pigmented
    lattice were noted. Scattered laser photocoagulation were placed in
    these areas. Lattice lesions were surrounded and treatment carried out
    to the aura. One retinal break was identified at the 1 o'clock
    position near the aura and this was treated with four rows of confluent
    laser around its margins and treated out to the aura. Total of
    approximately 1100 laser spots were placed. He tolerated the procedure
    well. The laser was turned off, the indirect ophthalmoscope was used
    to inspect the retina 360 and also the posterior pole and there was no
    change. Lid speculum was removed and he left the operating room in
    good condition to be followed postoperatively

    PROCEDURE: Laser photocoagulation for retinal detachment, right eye

    I used the laser indirect ophthalmoscope 500 micron
    spot size, Argon Green mode 0.1 second exposure time, power begun at
    200 milliwatts and gradually increased until moderate takes at the
    level of the outer retina and pigment epithelium could be achieved. I
    augmented scatter laser photocoagulation 360 degrees around the area of
    previous retinopexy and found one additional area that had not been
    treated in the region of previous detachment where irregular areas of
    pigmentation consistent with a lattice variant was noted. This was
    also surrounded with four rows of laser and carried out to be
    semiconfluent with the previous treatment more proliferatively. Laser
    turned off. Indirect ophthalmoscope inspection of the posterior pole
    showed no change.

  2. Default
    You have to use one code or the other, you can't use both due to CCI edits.

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