AHick asked:
The cystic; encapsulated bled was approached from superiorly 10-12 mm above the limbus. Sharp bent tip needle was used. A careful side to side sweeping motion performed to lyse the encapsulation surrounding the stent implant previously placed. Forceps were used to advance the stent sclerally beyond the encapsulation. Brisk efflux of fluid was noted following the lysis of adhesions. Immediate bled filtration noted upon puncture of capsule.
The subconjunctival dissection was performed with a sharp tip 25 gauge needle from distant conjunctival puncture site. Sweeping motions under the conjunctival bled was performed. Care was taken not to puncture the conjunctiva. Once the lysis was complete the diffuse bled was noted.
Should I use 66170 or 66250
The diagnosis is Uncontrolled glaucoma; encapsulated bled; status post IOL with CTR and Gel stent. This this help as to why the procedure was being done?
Answer:
We need more information as to why the procedure is being done.
66170 - Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery
The physician creates a new drainage tube for eye fluids through the fibrous covering of the eye. This is done to treat a condition in which fluid drains from the front chamber of the eye slower than new fluid is produced. The physician removes some of the tissue connecting the iris to the fibrous membrane that surrounds the eye; leaving a passage for fluid to drain into the space between the fibrous membrane and the other structures of the eye. Code [66172](https://www.findacode.com/code.php?set=CPT&c=66172) if this procedure is performed after a previous eye surgery to reduce scar tissue.
66250 - Revision or repair of operative wound of anterior segment; any type; early or late; major or minor procedure
The physician revises or repairs any type of wound to the front of the eye that resulted from surgery.
The cystic; encapsulated bled was approached from superiorly 10-12 mm above the limbus. Sharp bent tip needle was used. A careful side to side sweeping motion performed to lyse the encapsulation surrounding the stent implant previously placed. Forceps were used to advance the stent sclerally beyond the encapsulation. Brisk efflux of fluid was noted following the lysis of adhesions. Immediate bled filtration noted upon puncture of capsule.
The subconjunctival dissection was performed with a sharp tip 25 gauge needle from distant conjunctival puncture site. Sweeping motions under the conjunctival bled was performed. Care was taken not to puncture the conjunctiva. Once the lysis was complete the diffuse bled was noted.
Should I use 66170 or 66250
The diagnosis is Uncontrolled glaucoma; encapsulated bled; status post IOL with CTR and Gel stent. This this help as to why the procedure was being done?
Answer:
We need more information as to why the procedure is being done.
66170 - Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery
The physician creates a new drainage tube for eye fluids through the fibrous covering of the eye. This is done to treat a condition in which fluid drains from the front chamber of the eye slower than new fluid is produced. The physician removes some of the tissue connecting the iris to the fibrous membrane that surrounds the eye; leaving a passage for fluid to drain into the space between the fibrous membrane and the other structures of the eye. Code [66172](https://www.findacode.com/code.php?set=CPT&c=66172) if this procedure is performed after a previous eye surgery to reduce scar tissue.
66250 - Revision or repair of operative wound of anterior segment; any type; early or late; major or minor procedure
The physician revises or repairs any type of wound to the front of the eye that resulted from surgery.
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