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2025 CPT code 65757

Backbench preparation of a corneal endothelial allograft before transplantation.

Always report this code in conjunction with a primary keratoplasty code (e.g., 65756). Do not use this code with refractive keratoplasty procedures (65760, 65765, 65767).

Modifiers 50, 51, 52, and RT/LT may be applicable depending on the circumstances.

The medical necessity of code 65757 is directly tied to the medical necessity of the primary keratoplasty procedure (e.g., 65756).The preparation of the graft is an integral and essential part of the overall procedure, contributing to the success of the corneal transplant.The justification for the transplant must be clearly documented.

The ophthalmologist or a qualified surgical assistant performs this procedure.The clinical responsibility includes meticulous preparation of the donor graft to maximize the success of the corneal transplant.

IMPORTANT This code is always used in addition to a primary keratoplasty code (e.g., 65710, 65730, 65750, 65755, or 65756).It should not be reported with code 92025.

In simple words: The doctor prepares the donor cornea in the operating room before the corneal transplant. This involves carefully cleaning and preparing the tissue to ensure a successful transplant.

This add-on code encompasses the surgical preparation of a corneal endothelial allograft on a backbench before corneal transplantation during the same encounter.The procedure involves preparing the endothelial graft, potentially including steps like preparing an artificial anterior chamber (AAC), securing the donor cornea to the AAC, measuring pressure, removing corneal epithelium under a microscope, marking the donor cornea, measuring central corneal thickness using pachymetry, setting and inspecting a microkeratome to cut a corneal cap, retrieving and realigning the cap, and cleaning the recipient's cornea's membrane and endothelium. Irrigation, incision closure, antibiotic application, and patching are also included.

Example 1: A patient presents with Fuchs' endothelial dystrophy requiring endothelial keratoplasty (EK). The surgeon performs code 65756 (Endothelial Keratoplasty) and also performs code 65757 (Backbench Preparation) to prepare the graft before transplantation., A patient undergoes Descemet's membrane endothelial keratoplasty (DMEK).The surgeon uses code 65757 to bill for the meticulous preparation of the extremely delicate graft. The primary procedure is coded as 65756. , A patient with corneal endothelial disease undergoes a DSAEK procedure. The surgeon performs code 65756 and code 65757 for the preparation of the donor tissue.

Detailed operative report specifying the preparation steps undertaken.Preoperative and postoperative assessments of the patient's visual acuity. Documentation of the type of graft used (fresh or preserved) and its source.Images or videos documenting the procedure steps may be beneficial.

** This code reflects the preparation of the donor graft, a distinct surgical step requiring specific skills and precision before the actual corneal transplantation.The detailed documentation of these steps is crucial for proper reimbursement.

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