2025 CPT code 66991
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Extracapsular cataract removal with intraocular lens insertion and anterior segment aqueous drainage device placement.
Modifiers such as 50 (bilateral procedure), 51 (multiple procedures), and others may apply depending on the specific circumstances of the procedure.Consult the official CPT manual and payer guidelines for correct modifier application.
Medical necessity is determined based on the presence of cataracts and/or glaucoma, impacting the patient's vision and quality of life.Documentation should support the clinical need for the surgery and the chosen devices.
The ophthalmologist or qualified surgeon is responsible for the entire procedure including pre-operative evaluation, surgical technique, and post-operative care.
In simple words: This procedure removes a cloudy lens in the eye (cataract), inserts a replacement lens, and adds a tiny drainage device to lower eye pressure if needed. The doctor makes small incisions to perform these steps.
This CPT code encompasses extracapsular cataract extraction with concurrent insertion of an intraocular lens prosthesis and one or more anterior segment aqueous drainage devices.The procedure involves removing the lens nucleus and cortex, leaving the posterior capsule largely intact.Lens implantation follows, typically after irrigation and aspiration (I&A) or phacoemulsification. Anterior segment aqueous drainage device(s) are inserted into the trabecular meshwork via an internal approach, without an extraocular reservoir.The technique may utilize manual or mechanical methods.
Example 1: A 70-year-old patient presents with cataracts and mild glaucoma. The surgeon performs extracapsular cataract extraction with IOL implantation and inserts a single iStent to lower intraocular pressure., A 65-year-old patient with a history of glaucoma requires cataract surgery.The surgeon performs phacoemulsification, IOL implantation, and inserts two Hydrus devices during the same surgical session., A patient with a complex cataract and significant glaucoma undergoes extracapsular cataract extraction with IOL insertion, and the surgeon employs an innovative technique necessitating additional instrumentation, along with multiple anterior segment drainage devices.
Pre-operative evaluation including visual acuity, intraocular pressure measurement, gonioscopy, and dilated fundus examination; operative report detailing the surgical technique, devices used, and complications; post-operative visual acuity and intraocular pressure assessments; any necessary pathology reports.
** This code is frequently used in conjunction with codes for glaucoma and cataract diagnoses (ICD-10). Always ensure accurate linkage of the procedure code with the appropriate diagnostic codes.
- Revenue Code: P4B
- RVU: RVUs vary by geographic location and payer. Consult your local fee schedule or payer contract for specific RVU values.
- Global Days: The global period is not specified in the provided data, but typically includes post-operative care within a specific timeframe established by payer guidelines.
- Payment Status: Active
- Modifier TC rule: The use of TC (technical component) modifiers is dependent on the specific scenario and payer policies. Refer to payer-specific guidelines.
- Fee Schedule: Historical fee schedules are not provided but can be found through publicly available resources like CMS fee schedules or private payer contract agreements.
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Office