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2025 CPT code 65426

Excision or transposition of pterygium; with graft.

Refer to the official CPT manual and the most current coding guidelines for ophthalmologic procedures.

Modifiers may be applicable based on specific circumstances (e.g., 50 for bilateral procedures, 59 for distinct procedural services, 22 for increased procedural services).Refer to the CPT manual for detailed guidance on modifier usage.

Medical necessity is established by the presence of a symptomatic pterygium causing visual impairment, irritation, or discomfort that is not adequately managed by conservative measures.Documentation should support the need for surgical intervention.

The ophthalmologist or appropriately trained surgical specialist is responsible for the pre-operative assessment, surgical procedure, and post-operative care.

IMPORTANT:For pterygium excision without a graft, use CPT code 65420. If an amniotic membrane transplant is used with glue instead of a conjunctival graft, code 65426 remains appropriate.If a sutured amniotic membrane transplant is used in addition to a conjunctival autograft, CPT code 65779 (Placement of amniotic membrane on the ocular surface for wound healing; single layer, sutured) may also be reported.

In simple words: This surgery removes a growth on the white part of the eye (pterygium) and replaces the removed tissue with a graft. This improves vision and comfort.

This procedure involves the surgical removal (excision) or repositioning (transposition) of a pterygium, a noncancerous growth on the conjunctiva of the eye, followed by the placement of a graft to repair the resulting defect.The procedure begins with separating the pterygium from the underlying sclera. The entire pterygium is then excised, and bleeding is controlled using electrocautery.The conjunctiva is carefully separated from Tenon's capsule, and the size of the wound is assessed. A graft (conjunctival or amniotic) is harvested and placed on the scleral bed.The graft is secured with sutures, while the donor site is left open to heal naturally.

Example 1: A 55-year-old male patient presents with a symptomatic pterygium affecting his right eye, causing blurred vision and irritation.A conjunctival autograft is used to repair the defect after pterygium excision., A 40-year-old female patient has a large pterygium on her left eye that requires excision. Due to the size of the defect, an amniotic membrane transplant is used in addition to a conjunctival autograft for complete coverage., A 60-year-old patient undergoes pterygium excision with an amniotic membrane transplant secured with glue instead of sutures. No conjunctival autograft is used.

Detailed ophthalmologic examination notes documenting the presence and size of the pterygium, visual acuity measurements before and after the procedure, intraoperative photos or videos, type of graft used, and post-operative assessment including visual acuity and any complications.

** Always refer to the most current CPT and payer guidelines for accurate coding and reimbursement.

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