2025 CPT code 65767
(Active) Effective Date: N/A Revision Date: N/A Ophthalmology - Other Procedures on the Cornea Surgery Feed
Epikeratoplasty; a corneal surgery to improve vision by suturing a donor corneal disc onto the cornea.
Modifiers may apply depending on circumstances such as anesthesia provided by another physician (modifier 47) or if the procedure is performed on different eyes (bilateral modifier).
Medical necessity for epikeratoplasty is established when the patient demonstrates significant visual impairment due to corneal irregularity, and other conservative management options such as contact lenses have failed.The procedure must address functional visual impairment and not simply cosmetic concerns.Specific payer guidelines will need to be consulted to ensure medical necessity for reimbursement.
The ophthalmologist or a qualified surgeon performs the epikeratoplasty procedure.Responsibilities include patient preparation, anesthesia administration, corneal epithelium removal, donor disc preparation and suturing, and postoperative care.
In simple words: This eye surgery improves vision by replacing a damaged part of the cornea with a donor tissue disc.It's done for people who have trouble focusing due to an irregularly shaped cornea and can't tolerate contact lenses.
Epikeratoplasty is a refractive corneal surgery where a lens of human corneal tissue is sutured to the patient's deepithelialized cornea.This procedure is used to correct ametropia (inability to focus images on the retina due to irregular corneal shape) and may be indicated for patients intolerant to aphakic contact lenses. The procedure involves prepping the patient, administering local anesthesia, using an eyelid speculum to keep the eye open, removing the corneal epithelium, and then suturing a prepared donor corneal disc to the anterior cornea.
Example 1: A 60-year-old patient with keratoconus experiences significant vision impairment and is intolerant of contact lenses. Epikeratoplasty is performed to improve visual acuity., A 45-year-old patient with aphakia (absence of the eye's natural lens) undergoes epikeratoplasty to correct refractive error and improve vision., A 30-year-old patient with a history of corneal trauma resulting in a significant irregularity is a candidate for epikeratoplasty to restore visual function.
* Comprehensive patient history and physical exam documenting visual acuity and corneal condition.* Preoperative and postoperative visual acuity measurements.* Detailed operative report documenting surgical technique and complications (if any).* Pathology report (if applicable).* Documentation of patient's intolerance to contact lenses (if applicable).* Informed consent documentation.
** Always consult the most current CPT manual, payer-specific guidelines, and local coverage determinations (LCDs) before coding.Specific payer policies may determine coverage based on the patient's diagnosis, the necessity of the procedure, and other criteria.
- Revenue Code: P4A (EYE PROCEDURE - CORNEAL TRANSPLANT)
- RVU: This information requires accessing specific payer fee schedules and may vary based on location, facility type (inpatient vs. outpatient), and other factors.RVUs are not consistently available in publicly accessible datasets.
- Global Days : The global period for this procedure is not explicitly defined in the available data and will vary based on payer and local policies.Additional research is needed to determine the exact global period.
- Payment Status: Active (payment varies based on payer and other factors)
- Modifier TC rule: Technical component (TC) modifiers may apply; additional research is needed to determine specific applicability based on local policies and payer requirements.
- Fee Schedule : Historical fee schedule data is not provided in the source data. Information should be sought from specific payers and their associated fee schedules.
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Office