2025 CPT code 66740
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Surgical separation of the ciliary body from the sclera to reduce aqueous fluid production and lower intraocular pressure.
Modifiers may apply depending on specific circumstances (e.g., 50 for bilateral procedures, 59 for distinct procedural services). Refer to the official CPT guidelines for modifier usage.
Cyclodialysis is medically necessary for patients with uncontrolled glaucoma despite maximal medical and surgical therapy, particularly when vision is compromised or pain is a significant issue.The procedure should be considered only when less invasive methods have failed or are inappropriate.
The ophthalmologist or a qualified surgeon performs the procedure. Pre-operative assessment, surgical execution, and post-operative care are all components of the clinical responsibility.
In simple words: This surgery lowers eye pressure by detaching part of the ciliary body, a structure in the eye that makes fluid. This reduces the amount of fluid produced, leading to lower eye pressure. The surgeon makes a small cut, uses a tiny tool to separate the ciliary body, and then closes the cut.
Cyclodialysis is a surgical procedure where the ciliary body, located behind the iris and responsible for producing aqueous fluid in the eye, is separated from the scleral spur.This separation reduces aqueous fluid production, thus lowering intraocular pressure (IOP). The procedure involves an incision in the conjunctiva and sclera, insertion of a spatula into the anterior chamber, and separation of the ciliary body from its attachment at the scleral spur using the spatula, often aided by a gonioscope and slit lamp or operating microscope.The incision is closed with sutures, and a sterile solution may be injected to restore pressure; a pressure patch with antibiotic ointment may also be applied.
Example 1: A patient with refractory glaucoma, unresponsive to medications and previous surgeries, undergoes cyclodialysis to lower intraocular pressure and prevent further vision loss., A patient with neovascular glaucoma and poor visual potential opts for cyclodialysis as a less invasive alternative to other glaucoma surgeries that carry greater risk in their case., A patient with uncontrolled glaucoma, despite maximal medical therapy, undergoes cyclodialysis as a means of pain management given their significant vision impairment and discomfort.
Detailed ophthalmologic exam documentation (including IOP measurements before and after surgery, visual acuity assessments, gonioscopy findings, and retinal evaluation).Surgical notes including the type of anesthesia used, surgical technique, complications, and intraoperative findings.Postoperative care records noting any complications or changes in IOP and visual acuity.Documentation should also clearly support medical necessity based on previous treatment failures and the patient's overall clinical picture.
** This procedure is typically a last resort, reserved for patients with refractory glaucoma who have not responded to other treatments.Careful patient selection and comprehensive documentation are vital for appropriate coding and reimbursement.
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- RVU: The relative value units (RVUs) for this code will vary based on geographic location, facility type (inpatient vs outpatient), and other factors.Consult the relevant fee schedules for accurate RVU values.
- Global Days: The global period for this procedure may vary depending on the payer and specific circumstances.
- Payment Status: Active
- Modifier TC rule: The application of a Technical Component (TC) modifier might be applicable; however, this depends on the billing practice and the payer's requirements.
- Fee Schedule: Fee schedules are location and time dependent. Historical data can be referenced via specific billing platforms and databases relevant to the specific period and location in question.
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Office