2025 CPT code 65778
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Feed
Placement of amniotic membrane on the ocular surface; without sutures.
Modifiers such as 22 (Increased Procedural Services), 50 (Bilateral Procedure), RT (Right side), and LT (Left side) may be applicable.
Medical necessity must be established by documenting the presence of a corneal defect, persistent epithelial defect, or other ocular surface condition that warrants the use of an amniotic membrane for healing. The failure of conservative treatments should also be noted.
The procedure is performed by an ophthalmologist or a therapeutic optometrist. The eye is prepared and sterilized, and any damaged tissue or adhesions are removed. The amniotic membrane is then carefully placed on the ocular surface, sometimes using clips, without sutures. Topical antibiotics are applied, and the patient is monitored for healing.
In simple words: This procedure involves placing a natural tissue like a contact lens on the surface of your eye to help it heal. It doesn't use stitches and promotes faster healing. The healing effects are temporary, so the procedure might need to be repeated.
This code describes a procedure where a thin protective membrane (amniotic membrane) is placed on the eye's surface to aid in wound healing, particularly for corneal issues.The membrane is positioned like a contact lens and does not involve sutures for placement.It stimulates healing and reduces inflammation, but may need to be repeated as the effects are not permanent.This is a surgical procedure typically performed by ophthalmologists or therapeutic optometrists.
Example 1: A patient with a persistent corneal ulcer that is not responding to conventional treatment undergoes placement of an amniotic membrane to promote healing and reduce inflammation., Following surgical removal of a pterygium, an amniotic membrane is placed on the ocular surface to prevent recurrence and aid in healing., A patient with recurrent corneal erosion syndrome undergoes placement of an amniotic membrane to promote healing and reduce pain.
Documentation should include the diagnosis necessitating the procedure, the condition of the ocular surface, details of the procedure itself (including the type of amniotic membrane used), and any complications encountered.The medical necessity for the procedure must be clearly justified.
** The cost of the amniotic membrane itself is typically bundled into the reimbursement for the procedure and should not be billed separately, except for specific instances outlined by payers (such as HCPCS code V2790, with specific billing guidelines).
- Global Days: 0 days
- Payment Status: Active
- Specialties:Ophthalmology, Therapeutic Optometry
- Place of Service:Ambulatory Surgical Center, Office, Outpatient Hospital