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Thread: goniosynechialysis ?

  1. #1
    Join Date
    Apr 2007

    Default goniosynechialysis ?

    AAPC: Back to School
    Cannot find a cpt code for this , isit just a regular cataract 66984 , or complex , not sure about goniosynechialysis- any suggestions will help

    POSTOPERATIVE DIAGNOSES: 1. Visually significant cataract, O.D. 2. Chronic angle closure glaucoma with synechial adhesions between the cornea and iris near the angle.

    OPERATION: 1. Phacoemulsification with a posterior chamber intraocular lens implantation, O.D. 2. Goniosynechialysis, O.D.

    here is report
    After informed consent was obtained from the patient, the patient was wheeled into the operating room. The right eye was prepped and draped in the standard fashion for this procedure. Lids and eyelashes were secured with the help of a lid speculum. Preservative-free lidocaine, one drop x3, was placed on the surface of the cornea and conjunctiva. A 3 mm partial thickness limbal incision was performed in the inferotemporal quadrant. A paracentesis was performed in the superotemporal quadrant. Viscoelastic was injected into the anterior chamber so as to make the eye firm. Continuous capsulorrhexis was performed with the help of cystotome. Hydrodissection was performed with the help of BSS on a cannula. The nucleus was removed with the help of phacoemulsification. The remaining cortical material was removed with the help of irrigation/aspiration. A posterior chamber implant was inserted in the capsular bag without any complications. At this stage, using viscoelastic cannula, synechiolysis was performed in the angle almost 280 degrees. This was performed by moving the cystotome anterior to posterior direction in the angle by pushing the iris down away from the cornea. This resulted in a nice deepening of the anterior chamber with the iris falling back posteriorly. At the end of this procedure, no bleeding was noticed. Viscoelastic was washed out with the help of irrigation/aspiration procedure. The wound was closed with the help of a single interrupted 10-0 nylon. At the end of the operation, the cornea was clear, the anterior chamber was deep and well formed, and the intraocular lens was in a stable position with a bright red reflex behind it.

    A drop of pilocarpine and TobraDex were placed in the eye and the eye was covered with the help of a shield. The patient was transferred to the recovery room without any other complications.

  2. #2
    Join Date
    Apr 2007
    Lexington Kentucky Chapter


    Sounds like a (1) 66984 with (2) 65820-59; if an endoscope was also used report with 66990.

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