OSE_1303_part1_Layout 1 3/8/13 10:07 AM Page 43
CODING & BILLING
66250 Revision or repair of operative wound of anterior segment,
any type, early or late, major or minor procedure can be reported.
Code 66250 belongs to APC 0233 and has a Medicare national payment
rate of $1,129.46 under OPPS. It is paid at a Medicare national payment
rate of $633.77 under the ASC payment system.
Canaloplasty
Canaloplasty or canalplasty refers to procedures that dilate
Schlemm's canal, an endothelium-lined tube that drains aqueous
humor from the anterior chamber into the bloodstream via the anterior ciliary veins. Obstruction of this pathway can cause increased
intraocular pressure.
On January 1, 2011, 2 CPT Category III codes for dilation of
Schlemm's canal were converted to Category I codes. Report 66174
Transluminal dilation of aqueous outflow canal; without retention of
device or stent for dilation of the canal with fluid, after which a microcatheter is placed in the canal and then retracted as viscoelastic is
injected to further dilate Schlemm's canal. The microcatheter is
removed and the scleral flap that was created for access to Schlemm's
canal is sutured closed.
When a stent or other device (polypropylene suture, for example) is
placed to keep the canal patent, report 66175 Transluminal dilation of
aqueous outflow canal; with retention of device or stent.
The canaloplasty procedures belong to APC 0673, per the OPPS, and
M A R C H 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
4 3
