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66984???

  1. #1
    Exclamation 66984???
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    I need some extra eye's on this one... I am not sure if I should use 66984? should I use mod 52?? 66982?? Any help is much appreciated Thank you


    DESCRIPTION OF PROCEDURE: The patient was brought into the operating
    room, securely fastened onto the operating room table. The patient
    was prepped and draped in usual sterile fashion, including
    povidone-iodine solution to irrigate the fornices, exposing the left
    globe only. The lid speculum was carefully inserted within the
    fornices. Three drops of tetracaine solution were placed onto the
    cornea. A peripheral stab incision was placed through clear cornea at
    the 2 o'clock hour position. Lidocaine was injected to deepen the
    anterior chamber. Viscoat was instilled to deepen the anterior
    chamber. A phaco blade, 2.75 mm, was used to make a clear corneal
    incision at 12 o'clock.

    As I attempted to perform the capsulorrhexis, it was very apparent
    that the lens was freely mobile, and it was almost impossible to do a
    proper capsulorrhexis. I was able to open the anterior capsule
    approximately 3 mm, and I attempted to remove as much lens material
    as possible. Due to the fact that the lens was totally unstable and,
    at that point, I had no vitreous present, I decided to just insert an
    anterior chamber intraocular lens in the eye. I will refer to the
    patient to a vitreoretinal surgeon to safely remove the lens through
    a pars plana procedure within the next day or two.

    A corneal white to white measurement of 12 mm was taken. Viscoat was
    used to coat the surface of the iris. A peripheral iridotomy was
    placed at 12 o'clock using Vannas scissors.

    The intraocular lens was taken from a sterile container. It is an
    Alcon model MTA3U0, 18.0 diopters, serial number 12010917. A sheath
    glide was used to insert the anterior chamber intraocular lens safely
    with a 6 to 12 o'clock hour haptic orientation. The sheath glide was
    then removed. Examination revealed the implant to be well-centered,
    and the peripheral iridectomy was found to be patent. Balanced salt
    solution was gently inserted through the paracentesis tract to gently
    irrigate the viscoelastic out of the anterior chamber. The clear
    corneal incision was closed using 3 interrupted 10-0 nylon sutures.
    The wound was checked and found to be watertight.

  2. #2
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    Lexington Kentucky Chapter
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    Quote Originally Posted by KELLI View Post
    I need some extra eye's on this one... I am not sure if I should use 66984? should I use mod 52?? 66982?? Any help is much appreciated Thank you


    DESCRIPTION OF PROCEDURE: The patient was brought into the operating
    room, securely fastened onto the operating room table. The patient
    was prepped and draped in usual sterile fashion, including
    povidone-iodine solution to irrigate the fornices, exposing the left
    globe only. The lid speculum was carefully inserted within the
    fornices. Three drops of tetracaine solution were placed onto the
    cornea. A peripheral stab incision was placed through clear cornea at
    the 2 o'clock hour position. Lidocaine was injected to deepen the
    anterior chamber. Viscoat was instilled to deepen the anterior
    chamber. A phaco blade, 2.75 mm, was used to make a clear corneal
    incision at 12 o'clock.

    As I attempted to perform the capsulorrhexis, it was very apparent
    that the lens was freely mobile, and it was almost impossible to do a
    proper capsulorrhexis. I was able to open the anterior capsule
    approximately 3 mm, and I attempted to remove as much lens material
    as possible. Due to the fact that the lens was totally unstable and,
    at that point, I had no vitreous present, I decided to just insert an
    anterior chamber intraocular lens in the eye. I will refer to the
    patient to a vitreoretinal surgeon to safely remove the lens through
    a pars plana procedure within the next day or two.

    A corneal white to white measurement of 12 mm was taken. Viscoat was
    used to coat the surface of the iris. A peripheral iridotomy was
    placed at 12 o'clock using Vannas scissors.

    The intraocular lens was taken from a sterile container. It is an
    Alcon model MTA3U0, 18.0 diopters, serial number 12010917. A sheath
    glide was used to insert the anterior chamber intraocular lens safely
    with a 6 to 12 o'clock hour haptic orientation. The sheath glide was
    then removed. Examination revealed the implant to be well-centered,
    and the peripheral iridectomy was found to be patent. Balanced salt
    solution was gently inserted through the paracentesis tract to gently
    irrigate the viscoelastic out of the anterior chamber. The clear
    corneal incision was closed using 3 interrupted 10-0 nylon sutures.
    The wound was checked and found to be watertight.
    Reading the description in the Coding Companion for Ophthalmology, your procedure note reads as 66984. 66982 is for a noted (pre-operative) complicated cataract extraction, and while the surgeon did not complete the capsulorrhexis, this would not reduce the service performed. I would not append the -52.

    David Keown, CPC, OCS

  3. Default
    Reading the Op Notes, I undersatnd this would be more appropriate:

    1. It does not meet up with reduced service, just because of the technical reason the physicians work will not be reduced.
    2. it does not address to the description sof 66982, as a complex in its true sense.
    3. It is an ECCE- meaning, it is a cotaract surgery- one in which the nucleus of lens capsule and/or the front (anterior) shell are (is) removed.
    4. the parenthetical notes "Tocode implant at time of concurent cataract surgery, see 66982, 66983, 66984"; our case fits into 66984. to assign this code, it has to be a "cataract surgery", meaning not necessarily a"removal"!!
    So I think I am comfortable with 66984.
    Thank you

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