2025 CPT code 66821
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Feed
Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (e.g., YAG laser) (one or more stages)
Modifiers may be applicable in certain circumstances, such as bilateral procedures (modifier 50) or unusual circumstances (modifier 22). Modifiers should only be appended when documentation clearly supports their usage according to established guidelines.
Medical necessity is established by the presence of a secondary membranous cataract that significantly impairs vision following cataract surgery. The documentation must support the patient’s visual impairment and the need for the procedure to restore visual clarity.
The ophthalmologist dilates the pupil with anesthetic eye drops, then focuses the YAG laser on the clouded capsule to create an opening.Multiple laser applications may be used. Anti-inflammatory drops are instilled after the procedure.
In simple words: This procedure uses a laser to clear up cloudiness that can sometimes occur after cataract surgery.The laser creates a small hole in the membrane behind the lens to restore clear vision.
This code describes a procedure where a laser, typically a YAG laser, is used to create an opening in the opacified posterior lens capsule and/or anterior hyaloid in the eye to treat secondary membranous cataracts.The procedure may involve one or more stages/sessions within the global period.
Example 1: A patient who underwent cataract surgery 6 months prior presents with blurred vision due to posterior capsule opacification.The ophthalmologist performs a YAG laser capsulotomy (66821) to clear the clouded capsule., A patient with a secondary membranous cataract experiences decreased visual acuity. The ophthalmologist performs 66821 using a YAG laser to create an opening in the affected membrane, thereby improving the patient's vision., A patient returns to the ophthalmologist four weeks post-cataract surgery with complaints of blurry vision and glare. After examination, the ophthalmologist determines that a secondary cataract has formed and performs 66821 to address the issue.
Documentation should include details of the patient’s prior cataract surgery, symptoms related to the secondary cataract, ophthalmic examination findings such as visual acuity measurements and slit-lamp examination results, type of laser used, and number of laser applications.
** “One or more stages” means any number of YAG laser sessions within the 90-day global period are included in 66821. For the same procedure using a Ziegler or Wheeler knife, use code 66820.
- Global Days : 90 days
- Payment Status: Active
- Specialties:Ophthalmology
- Place of Service:Office, Ambulatory Surgical Center, Outpatient Hospital