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The CPT® Code 66990 refers to the use of an ophthalmic endoscope, which is a specialized instrument designed to enhance the visualization of the eye's internal structures, particularly the anterior chamber, lens, and posterior segment. This tool offers superior clarity compared to traditional operating microscopes, making it particularly beneficial for specific surgical procedures. The process begins with the creation of two small incisions, known as stab incisions, in the limbus, which is the border between the cornea and the sclera. Through one of these incisions, a cannula is introduced, allowing for the injection of viscoelastic material. This material serves to improve the visibility of the surgical area by creating space and maintaining the shape of the eye during the procedure. Following this, the ophthalmic endoscope is inserted through the second stab incision, enabling the surgeon to conduct a thorough examination of the surgical site. The insights gained from this endoscopic evaluation are crucial for determining the most effective surgical approach tailored to the patient's needs. Subsequently, the physician can proceed with the corrective procedure, utilizing the enhanced visualization provided by the endoscope as necessary throughout the operation.
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The use of an ophthalmic endoscope, as described by CPT® Code 66990, is indicated for specific surgical scenarios where enhanced visualization of the eye's internal structures is essential. The following conditions may warrant the use of this procedure:
The procedure utilizing CPT® Code 66990 involves several critical steps to ensure effective use of the ophthalmic endoscope. The following outlines the procedural steps:
Post-procedure care following the use of the ophthalmic endoscope involves monitoring the patient for any immediate complications and ensuring proper recovery. Patients may be advised to follow specific postoperative instructions, which could include the use of prescribed eye drops to prevent infection and reduce inflammation. Regular follow-up appointments are essential to assess healing and the success of the surgical intervention. The physician will evaluate the patient's vision and overall eye health during these visits, making any necessary adjustments to the treatment plan based on the recovery progress.
| Short Descr | OPHTHALMIC ENDOSCOPE ADD-ON | Medium Descr | USE OPHTHALMIC ENDOSCOPE | Long Descr | Use of ophthalmic endoscope (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 20 - Other intraocular therapeutic procedures |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 65820 | Modifier 63 Exempt MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Goniotomy | 65875 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae | 65920 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Removal of implanted material, anterior segment of eye | 66985 | MPFS Status: Active Code APC J1 ASC A2 PUB 100 CPT Assistant Article Illustration for Code Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal | 66986 | MPFS Status: Active Code APC J1 ASC A2 PUB 100 CPT Assistant Article Illustration for Code Exchange of intraocular lens | 67036 | MPFS Status: Active Code APC J1 ASC A2 PUB 100 CPT Assistant Article Illustration for Code Vitrectomy, mechanical, pars plana approach; | 67039 | MPFS Status: Active Code APC J1 ASC A2 PUB 100 CPT Assistant Article Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation | 67040 | MPFS Status: Active Code APC J1 ASC A2 PUB 100 CPT Assistant Article Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation | 67041 | MPFS Status: Active Code APC J1 ASC G2 PUB 100 CPT Assistant Article Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) | 67042 | MPFS Status: Active Code APC J1 ASC G2 PUB 100 CPT Assistant Article Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) | 67043 | MPFS Status: Active Code APC J1 ASC G2 PUB 100 CPT Assistant Article Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and laser photocoagulation | 67113 | MPFS Status: Active Code APC J1 ASC G2 PUB 100 CPT Assistant Article Illustration for Code Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens |
| LT | Left side (used to identify procedures performed on the left side of the body) | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2003-01-01 | Added | First appearance in code book in 2003. |
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