2025 CPT code 65920
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Removal of implanted material from the anterior segment of the eye.
Modifiers may apply depending on the circumstances of the procedure.Refer to the CPT manual and your payer's specific guidelines for modifier usage.Common modifiers include those for bilateral procedures (50), multiple procedures (51), reduced services (52), and others.Consult the appropriate CPT guidelines for specific modifier application.
Medical necessity is established by the presence of complications (e.g., infection, inflammation, dislocation) related to the implanted material or by the failure of the implant to achieve the desired clinical outcome. Documentation must support the need for the removal of the lens.The procedure must be determined clinically necessary by the treating physician.
The ophthalmologist or qualified surgeon is responsible for all aspects of the procedure, including patient preparation, anesthesia administration, surgical technique, and post-operative care.
In simple words: The doctor removes a previously implanted artificial lens or other material from the front part of the eye during surgery.
This procedure involves the surgical removal of previously implanted material, such as an artificial intraocular lens (IOL), from the anterior segment of the eye.The surgeon prepares the patient, administers anesthesia, uses a lid speculum for exposure, and performs a paracentesis to inject anesthetic. A corneal incision is made to access the anterior chamber, the implanted material is removed, and the incision is closed with sutures.
Example 1: A patient with a dislocated intraocular lens (IOL) after cataract surgery requires surgical repositioning or removal of the IOL.Code 65920 would be used to bill for the removal of the dislocated lens., A patient experiences complications from an IOL implantation, such as inflammation or infection, requiring the removal of the IOL. Code 65920 would be appropriate for billing., A patient had an IOL implanted years prior, but it is now causing vision problems and needs to be removed. This scenario is covered by 65920.
* Preoperative and postoperative evaluation notes documenting the patient's condition and the need for IOL removal.* Operative report detailing the surgical procedure, including the type of implanted material removed, the surgical approach, and any complications encountered.* Intraoperative images or videos demonstrating the location and removal of the IOL.* Any relevant laboratory or imaging studies, such as optical coherence tomography (OCT) or ultrasound biomicroscopy.
** This code is specifically for the removal of implanted material in the anterior segment of the eye.If the material is in the posterior segment, a different code is required (67121).
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: The application of a technical component (TC) modifier is not typically applicable to this code.
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Inpatient Hospital