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2025 CPT code 65755

Keratoplasty (corneal transplant); penetrating (in pseudophakia).

The correct code selection depends on the status of the crystalline lens. Use 65755 for pseudophakic patients, 65750 for aphakic patients and 65730 for phakic patients.

Modifiers may be applicable. Modifier 22 (Increased Procedural Services) might be used for significantly complex cases.

Medical necessity must be clearly documented and should indicate that the patient's vision is significantly impaired by corneal disease, and less invasive treatments are not suitable.

The ophthalmologist performs the surgery, including prepping the donor cornea, removing the diseased cornea, suturing the donor cornea in place, and ensuring the existing IOL is stable and functioning correctly.

In simple words: A full corneal transplant is performed where the entire cornea is replaced with a healthy donor cornea. This is done on an eye that already has an artificial lens implant from a previous cataract surgery.

This procedure involves a full-thickness corneal transplant (penetrating keratoplasty) performed on a patient who has a pseudophakic eye, meaning they have an artificial lens implant (intraocular lens or IOL) in place following previous cataract surgery. The procedure replaces the entire thickness of the diseased cornea with a donor cornea. The existing IOL from the prior cataract surgery remains in place.The donor material preparation is included in the code.

Example 1: A 70-year-old patient with a history of cataract surgery and an IOL implant develops corneal scarring that significantly impacts vision. A penetrating keratoplasty using code 65755 is performed., A 50-year-old patient with an IOL following earlier cataract surgery experiences corneal edema after an injury, and their vision is severely reduced. They undergo penetrating keratoplasty using code 65755., A patient with an IOL develops a corneal infection causing significant corneal damage. After treating the infection, they undergo penetrating keratoplasty using code 65755 to restore corneal clarity and vision.

Documentation should include the diagnosis necessitating the transplant, pre-operative visual acuity measurements, details of the surgical technique including donor tissue preparation, and post-operative care plan.

** This information is current as of December 1, 2024.For the most up-to-date information, please consult the latest CPT coding manuals and payer guidelines.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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