2025 CPT code 66990
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Feed
Use of ophthalmic endoscope (List separately in addition to code for primary procedure)
Modifiers may apply to the primary procedure code, but not directly to the add-on code 66990.
Medical necessity must be substantiated by the clinical indication for the primary surgical procedure and the need for enhanced visualization due to obscured views from conditions such as dense cataracts, vitreous hemorrhage, or corneal scarring. The use of the endoscope should be documented as essential for the successful completion of the primary procedure.
The physician performs the procedure, including prepping and anesthetizing the patient, making and closing the incision, inserting and removing the endoscope, restoring intraocular pressure, and applying medications.It requires expertise in ophthalmic surgical techniques.
In simple words: The doctor uses a tiny camera, called an endoscope, to look inside your eye during surgery. This helps them get a better view, especially if something is blocking their regular view.It's always used with another eye procedure.
This add-on code describes the use of an ophthalmic endoscope to examine the internal structures of the eye.It involves making a scleral incision, inserting the endoscope, visualizing internal structures, removing the scope, closing the incision, and restoring intraocular pressure.This code is used in conjunction with a primary eye procedure.
Example 1: A patient with a dense cataract requires retinal surgery. The ophthalmologist uses an endoscope (66990) in conjunction with the primary procedure to visualize the retina due to the obscured view., During a vitrectomy (e.g., 67039), the surgeon encounters unexpected bleeding that obscures visualization. An ophthalmic endoscope (66990) is used to continue the procedure effectively., A patient with prior trauma and corneal scarring requires retinal detachment repair.The surgeon uses an ophthalmic endoscope (66990) alongside the primary repair (e.g. 67107) to ensure adequate visualization of the peripheral retina.
Documentation should support the medical necessity of using the ophthalmic endoscope, the primary procedure performed, and a description of the findings. It should also include details about the insertion and removal of the endoscope, any complications, and post-operative care.
** For diagnostic and treatment ophthalmological services, refer to Medicine, Ophthalmology section, and codes 92002 et seq.Do not report code 69990 in addition to codes 65091-68850.
- Revenue Code: P8I - ENDOSCOPY - OTHER
- Payment Status: Active
- Modifier TC rule: No information found.
- Specialties:Ophthalmology, Vitreoretinal Surgery
- Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient