2025 CPT code 66184
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Revision of an aqueous shunt to an extraocular equatorial plate reservoir without a graft.
Modifiers may be applicable depending on the circumstances of the procedure.Refer to the CPT codebook for information on appropriate modifiers.Common modifiers may include -58 (staged or related procedure), -59 (distinct procedural service), or others as clinically indicated.
Medical necessity for revision of an aqueous shunt is established by documentation of uncontrolled glaucoma despite initial shunt implantation.The patient must exhibit signs and symptoms of elevated intraocular pressure necessitating surgical intervention. This should be supported by appropriate clinical findings.
The ophthalmologist is responsible for performing the preoperative evaluation, obtaining informed consent, performing the surgical procedure, and providing postoperative care.This may involve assessing the patient's response to the initial surgery, determining the need for revision, performing the revision surgery, and monitoring the patient's recovery. Anesthesiologist may be involved for anesthesia.
In simple words: This code represents a surgical procedure to fix a previously placed device in the eye that helps drain fluid.The doctor revises the device if the initial surgery wasn't successful in controlling eye pressure.
This CPT code, 66184, describes the revision of a previously implanted aqueous shunt to an extraocular equatorial plate reservoir.The procedure is performed via an external approach and does not involve the use of a graft.The revision is typically necessary when a patient fails to respond to or stops responding to the initial surgery, and adjusting the shunt is deemed beneficial. The surgeon will open the previous conjunctival incision, reposition or replace the tube or plate reservoir on the sclera (the white part of the eye) at the equator, close the conjunctiva, flush the site with saline, and close the site with layered sutures.
Example 1: A 65-year-old male patient with glaucoma underwent aqueous shunt implantation six months ago.He is experiencing a recurrence of elevated intraocular pressure.Revision of the aqueous shunt (66184) is performed to address this issue., A 72-year-old female patient with glaucoma had an aqueous shunt implanted one year ago. The shunt has become dislodged, requiring revision (66184) to restore proper function and maintain adequate intraocular pressure., A 58-year-old patient with post-traumatic glaucoma requires revision of a previously placed aqueous shunt due to inflammation and impaired drainage. The revision (66184) is necessary to restore proper fluid dynamics and reduce intraocular pressure.
Complete ophthalmologic examination documentation including visual acuity, intraocular pressure measurements (before and after the procedure), gonioscopy findings, and documentation supporting medical necessity.Surgical notes should include detailed descriptions of the procedure, including the type of shunt and any complications. Postoperative notes detailing patient recovery and any complications should also be included.
** Accurate coding requires complete and detailed documentation of the procedure and the clinical justification for the revision.Keep abreast of updates to CPT codes and NCCI edits to ensure accurate billing practices.Always consult payer-specific guidelines for reimbursement.
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- RVU: The specific Relative Value Units (RVUs) for this code will vary based on geographic location, facility type, and other factors.Consult the relevant fee schedules for the most up-to-date information.Medicare reimbursement data is available from the CMS website.
- Global Days: The global surgical period for this procedure may vary depending on payer and local guidelines.Check payer-specific policies for accurate information.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is usually not applicable to this code.The procedure is typically performed by the physician, with the professional component being the primary focus.
- Fee Schedule: Historical fee schedule data for this code can be obtained from sources like the CMS website or private payer websites. These amounts are subject to change based on geographic location and other factors.Note that reimbursement amounts have been affected by bundling changes.
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient Department, Office