2025 CPT code 65430
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Corneal scraping for diagnostic smear and/or culture.
Modifiers -26 (professional component) and -TC (technical component) may be applicable depending on who performs the procedure and who provides the equipment and facilities. Modifier 50 is used if the procedure is performed bilaterally.
Medical necessity for a corneal scraping is established when there is a clinical suspicion of corneal infection, inflammation, or other abnormality.This may be based on patient symptoms (pain, redness, blurred vision), physical examination findings, and/or prior history.The scraping provides crucial diagnostic information necessary for appropriate treatment.
The ophthalmologist or other qualified healthcare professional is responsible for performing the corneal scraping, preparing the sample, and sending it to the lab for analysis.Interpretation of the results is often done by a pathologist or microbiologist.
In simple words: The doctor gently scrapes the surface of the eye's clear front part (cornea) to collect a small sample. This sample is checked under a microscope to see if there's an infection or other problem.
This procedure involves scraping the cornea to obtain a sample for microscopic examination (smear) and/or microbiological culture to diagnose corneal infections, diseases, or abnormalities.The procedure typically begins with prepping and anesthetizing the patient's eye.Using an operating microscope and slit lamp, the provider uses a sterile needle or platinum loop to gently scrape the corneal surface, collecting a sample. This material is then spread on a slide and sent to a laboratory for analysis.
Example 1: A patient presents with a suspected corneal ulcer.A corneal scraping is performed to identify the causative organism (bacteria, fungus, or other)., A contact lens wearer experiences persistent corneal irritation.A corneal scraping is done to rule out infectious keratitis., A patient sustains a corneal injury.A scraping is performed to assess for the presence of foreign bodies or infection.
* Patient's medical history, including any eye conditions, contact lens use, or trauma.* Detailed description of the procedure performed, including the instruments used and the amount of tissue collected.* Location of the scraping on the cornea (if applicable).* Laboratory results from the smear and/or culture.* Documentation of any complications or adverse events.* Pre- and post-operative photographs (optional but beneficial).
** The amount of tissue collected during the corneal scraping procedure should be clinically appropriate to obtain sufficient material for testing but avoid unnecessary trauma to the cornea.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- RVU: Information not available in provided text.Refer to Medicare fee schedules and local coverage determinations for reimbursement rates.
- Global Days: Information not available in provided text.
- Payment Status: Active
- Modifier TC rule: Modifier -TC (Technical Component) may apply if the physician did not perform the scraping but merely interpreted the laboratory results.
- Fee Schedule: Information not available in provided text. Consult historical Medicare fee schedules and other payer-specific data for past reimbursement rates.
- Specialties:Ophthalmology
- Place of Service:Office, Ambulatory Surgery Center, Hospital Outpatient Department