2025 CPT code 65260
Effective Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Feed
Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route.
Modifiers may be applicable to 65260. For example, modifier -59 may be necessary if performed with other procedures that are normally bundled.Modifiers for laterality (RT, LT) should also be used to specify which eye was treated.
Medical necessity for 65260 is established by the presence of an intraocular foreign body that poses a threat to vision or ocular health. Supporting documentation should demonstrate the presence of the foreign body (e.g., imaging studies) and the symptoms or potential complications justifying its removal.
The ophthalmologist is responsible for the entire procedure, from prepping and anesthetizing the patient to locating and removing the foreign body and closing the surgical site. This includes careful examination of the eye structures, precise manipulation of the magnet and forceps, and ensuring the integrity of the eye after the foreign body removal.
In simple words: This procedure removes a metal object from the back of the eye using a magnet. The surgeon goes in through either the front or back of your eye to get the metal out. They use a special magnet to pull the metal piece toward them, and then tiny tweezers to grab and remove it. After that, they stitch up the area where they went in.
This procedure involves the removal of a metallic foreign body from the posterior segment of the eye using a magnet.The surgeon accesses the posterior segment either through the anterior (front) or posterior (back) of the eye.After the patient is prepped and anesthetized, the surgeon examines the anterior chamber, retina, and posterior chamber to locate the metallic foreign body. An intraocular magnet is then inserted to lift the foreign body, and forceps are used to grasp it from the magnet and remove it from the eye. The incision site is then closed with sutures.
Example 1: A patient presents with a metallic foreign body embedded in the vitreous following a workplace accident involving metal shards. The foreign body is confirmed by imaging, and 65260 is used for its removal via a posterior approach., A patient experiences blurred vision after hammering metal. Imaging reveals a metallic foreign body in the retina. Due to its location, an anterior approach is chosen for removal, and 65260 is billed., A child presents with a small metallic foreign body in the posterior segment after playing with a toy containing magnets.The foreign body is successfully removed with a magnet via an anterior approach, and 65260 is coded.
Documentation should include details about the foreign body (size, location, composition if known), the surgical approach used (anterior or posterior), the method of extraction (magnetic), intraoperative findings (damage to surrounding structures), and any complications encountered. Pre- and postoperative visual acuity measurements should also be documented.
** When reporting 65260, it's crucial to confirm that the foreign body is located in the posterior segment and not in the anterior chamber or lens (65235) or embedded in the eyelid (67938). It’s important to accurately document the surgical approach (anterior or posterior) and the method of extraction, along with supporting imaging studies and clinical findings, for accurate coding and reimbursement.
- Revenue Code: P4E - EYE PROCEDURE - OTHER
- Specialties:Ophthalmology, specifically vitreoretinal surgery.
- Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Inpatient Hospital