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2025 CPT code 67250

Scleral reinforcement without the use of a graft.

Refer to CPT guidelines for correct coding of scleral reinforcement procedures. Ensure appropriate use of modifiers if applicable. Do not report 67250 in conjunction with other codes that describe integral components of the same surgical procedure.

Modifiers may be applicable to 67250 depending on the specific circumstances of the procedure. Refer to current CPT modifier guidelines for appropriate usage.

Medical necessity for 67250 is established by demonstrating the presence of a weakened or thinning sclera that poses a risk to the patient's vision.This can be supported by diagnostic findings and clinical examination.

The ophthalmologist performs the surgical procedure, including prepping the patient, administering anesthesia, making incisions, and suturing the sclera.

IMPORTANT:For scleral reinforcement with graft, use 67255.

In simple words: This procedure strengthens the white part of the eye (sclera) when it is weak, without using any extra material. It helps protect the central part of the retina responsible for sharp vision (macula) in cases of severe nearsightedness.

This procedure involves strengthening and securing a weakened sclera without using a graft.It may be performed to avoid further damage to the macula from extreme myopia. The procedure involves making incisions to expose the sclera and then folding and suturing the stretched scleral connective tissue.

Example 1: A patient with high myopia experiences progressive thinning of the sclera, putting them at risk of macular damage. Scleral reinforcement (67250) is performed to strengthen the sclera and prevent further vision deterioration., Following trauma to the eye, a patient develops a localized area of scleral thinning.To prevent further complications, 67250 is performed to reinforce the weakened area., A patient with a scleral ectasia undergoes 67250 to stabilize the eye and prevent further progression of the condition.

Documentation should include the diagnosis necessitating the procedure (e.g., high myopia, scleral ectasia), preoperative evaluation including visual acuity and imaging studies, details of the surgical technique used, and postoperative care plan.

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