2025 CPT code 66986
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Anterior Segment of the Eye Feed
Exchange of intraocular lens.
Modifiers are applicable. Examples include modifier 50 for bilateral procedures, modifier 22 for increased procedural services, and modifier 78 for unplanned return to the operating room. Refer to current CPT guidelines for appropriate modifier usage.
Medical necessity must be established by documenting the patient’s visual impairment or complications directly related to the existing intraocular lens, which significantly impacts their quality of life and requires surgical intervention.The documentation should clearly explain why a lens exchange is necessary and the expected improvement in vision or reduction of complications.
The physician performs the surgery, including making the incision, removing the old lens, potentially performing a vitrectomy, inserting the new lens, checking for leaks, and closing the incision.
In simple words: This procedure replaces an existing artificial lens implant in the eye with a new one. The eye is numbed, a small cut is made, the old lens is taken out, and a new one is put in.The doctor then checks for leaks and closes the cut.
The procedure involves removing a previously placed intraocular lens and inserting a new one.After administering local anesthesia, an incision is made in the limbus or temporal area. The existing lens is removed, and if necessary, an anterior vitrectomy is performed. A new intraocular lens with the correct power is then inserted. A balanced salt solution is injected to check for leaks, and the incision is closed.
Example 1: A patient has an intraocular lens that is dislocated or not positioned correctly, requiring surgical exchange., A patient has an intraocular lens with the incorrect power, causing vision problems, and needs a lens exchange., A patient experiences complications such as inflammation or damage related to the existing intraocular lens, necessitating removal and replacement.
Documentation should include the reason for the lens exchange (e.g., dislocation, incorrect power, complications), operative report detailing the procedure, type of lens implanted, and any complications encountered. Pre- and postoperative visual acuity measurements should also be documented.
- Revenue Code: P4B - EYE PROCEDURE - CATARACT REMOVAL/LENS INSERTION
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center,Outpatient Hospital