CPT code 66711 is used for billing the procedure of ciliary body destruction, typically for glaucoma treatment.
CPT code 66711 is used to denote the procedure of ciliary body destruction, typically performed using cyclophotocoagulation. This procedure is aimed at reducing the production of aqueous humor to lower intraocular pressure, commonly used in the treatment of glaucoma when other treatments have not been effective. The method involves applying laser energy to the ciliary body, the part of the eye responsible for fluid production, to decrease fluid output and thereby reduce pressure within the eye.
For CPT code 66711, which refers to ciliary body destruction without concomitant removal of a lens, several modifiers may be applicable depending on the specific circumstances of the procedure and billing requirements. Here is an ordered list of common modifiers that might be used with this code and the reasons for each:
1. -50 Bilateral Procedure: If the procedure is performed on both eyes during the same operative session, this modifier should be used to indicate that the service was bilateral.
2. -RT Right Side and -LT Left Side: These modifiers are used to specify which eye underwent the procedure. -RT is used for the right eye and -LT for the left eye. These are particularly important if the procedure is only performed on one eye.
3. -22 Increased Procedural Services: This modifier may be used if the work required to perform the procedure is substantially greater than typically required. Documentation must support the increased effort.
4. -52 Reduced Services: If the procedure is partially reduced or eliminated at the physician's discretion, this modifier should be applied. Documentation should clearly justify the reduction.
5. -59 Distinct Procedural Service: Used to indicate that the procedure is not typically bundled with other services but is distinct and separate when performed on the same day.
6. -51 Multiple Procedures: This modifier is used when multiple procedures are performed during the same surgical session. It helps in adjusting the reimbursement for multiple procedures to account for overlapping resources.
7. -53 Discontinued Procedure: Applied when a procedure is terminated after it has begun but before it is completed due to extenuating circumstances or those that threaten the well-being of the patient.
8. -73 Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia: Similar to -53 but specific to outpatient or ASC settings, indicating that the procedure was canceled prior to anesthesia administration.
9. -74 Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure After the Administration of Anesthesia: Used when the procedure is discontinued after anesthesia is administered but before the procedure is performed.
Each of these modifiers serves a specific purpose and should be used accurately to ensure proper billing and reimbursement. It is crucial to check with specific payer policies as the applicability and rules surrounding modifiers can vary.
CPT code 66711, which refers to ciliary body destruction by cyclophotocoagulation or cyclocryotherapy, is generally reimbursed by Medicare. However, the specific amount of reimbursement can vary based on the geographic location and the setting in which the procedure is performed (e.g., outpatient hospital, ambulatory surgical center, or physician's office). It's important for healthcare providers to check the Medicare Physician Fee Schedule (MPFS) for the exact reimbursement rates applicable in their region. Additionally, providers should ensure that the procedure is medically necessary and properly documented to facilitate appropriate reimbursement.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately detecting underpayments. With the capability to scrutinize contracts and identify discrepancies down to specific CPT codes, such as 66711 for ECP ciliary body destruction, RevFind ensures that each claim is fully compensated according to your payer agreements. Schedule a demo today to see how RevFind can help secure the payments you are entitled to, for every procedure and every payer.
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