Payment will be 100% of the highest allowable and 50% of the lower allowable.ĬPT CODE DESCRIPTORS FOR RETINAL LASER TREATMENTSĦ7105: Repair of a retinal detachment, including drainage of subretinal fluid when performed photocoagulation.Ħ7145: Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage, one or more sessions photocoagulation.Ħ7210: Destruction of localized lesion of retina (eg, macular edema, tumors), one or more sessions photocoagulation.Ħ7220: Destruction of localized lesion of choroid (eg, choroidal neovascular membrane), one or more sessions photocoagulation (eg, laser).Ħ7228: Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation. NCCI edits override separate procedure language for Medicare and other payers that follow Medicare’s rules.Ĭorrect Coding: The correct coding for this case is 67025-RT and 65800-RT. The correct code for this case is 67025.Īs a paracentesis of the anterior chamber was performed, submitting the code 65800 in addition to 67025 is correct there is no National Correct Coding Initiative (NCCI) bundle. The surgical procedure was performed due to subretinal hemorrhage, and the description for 67110 requires the repair of an RD. CPT code 67110, repair of RD by injection of air or other gas, is not correct. What to Consider: In this case, pneumatic retinopexy is performed to displace the subretinal hemorrhage.
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