2025 CPT code 66920
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Removal of lens material; intracapsular.
Modifiers may be applicable depending on the circumstances; consult the current CPT guidelines and local payer guidelines for appropriate modifier use.
Medical necessity for 66920 is established when the cataract significantly impairs vision and interferes with daily activities, and other less invasive treatments have failed or are deemed inappropriate.The procedure should be documented as medically necessary to justify reimbursement.
The ophthalmologist or surgeon is responsible for prepping the patient, administering anesthesia, creating the incision, inserting and manipulating the cryoprobe, removing the lens, closing the incision, restoring intraocular pressure, administering topical antibiotics, and applying an eye patch.Post-operative care may involve monitoring intraocular pressure and managing any complications.
In simple words: The doctor removes the cloudy lens of the eye, along with its capsule, using a very cold instrument to improve vision.The procedure involves making a small incision in the eye, removing the lens, closing the incision, and giving antibiotics and eye drops.
Intracapsular removal of lens material from the eye.This procedure involves the removal of the entire lens and its surrounding capsule using a cryoprobe, which freezes the lens to facilitate removal.The procedure includes the creation of an incision at the border of the cornea and sclera, the introduction of the cryoprobe into the anterior chamber, freezing and extraction of the lens, closure of the incision with sutures, restoration of intraocular pressure, administration of topical antibiotics, and application of an eye patch.
Example 1: A 70-year-old patient presents with a dense cataract in the right eye, significantly impairing vision.Intracapsular cataract extraction (66920) is performed using a cryoprobe., A 65-year-old patient experiences a traumatic lens dislocation. The surgeon performs intracapsular lens material removal (66920) to address the dislocated lens., An 80-year-old patient has a dense, hard cataract that is difficult to remove with other techniques. The surgeon chooses intracapsular lens material removal (66920) due to the lens's hardness and firmness.
* Pre-operative assessment including visual acuity, intraocular pressure, and dilated fundus examination.* Operative report detailing the procedure performed (incision, cryoprobe use, lens extraction, closure technique).* Post-operative assessment of visual acuity, intraocular pressure, and any complications.* Documentation of topical antibiotic administration and post-operative instructions.
** This procedure is less common now due to advances in phacoemulsification and other extracapsular cataract extraction techniques.Careful documentation of medical necessity is essential for reimbursement.
- Revenue Code: P4B (EYE PROCEDURE - CATARACT REMOVAL/LENS INSERTION)
- RVU: Not specified in provided data; consult current CPT guidelines and local payer reimbursement schedules.
- Global Days: Not specified in the provided data.The global period may vary depending on payer and other factors; consult current CPT guidelines and local payer reimbursement schedules.
- Payment Status: Active
- Modifier TC rule: Technical Component (TC) modifier is not applicable to this code as it describes a complete procedure.
- Fee Schedule: Historical fee schedule data is not provided. Check historical CPT codebooks and fee schedules for specific information.
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center, Office, Inpatient Hospital