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Official Description

Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 67005 involves the removal of vitreous humor from the eye using an anterior approach, which can be performed through either an open sky technique or a limbal incision. The vitreous humor is a clear, gel-like substance that occupies the posterior chamber of the eye, playing a crucial role in maintaining the shape of the eyeball and providing a pathway for light to reach the retina. In the open sky technique, a direct incision is made in the cornea, allowing access to the vitreous. Alternatively, the limbal incision is made at the limbus, the junction where the cornea meets the sclera, providing another access point for the procedure. The process of vitreous removal involves several key components: the cutting of vitreous strands, suction to remove the gel-like substance, and the infusion of saline to maintain the eye's structure during the procedure. In the context of CPT® Code 67005, the partial removal of the vitreous is achieved using a needle or scissors, distinguishing it from CPT® Code 67010, where a mechanical device such as a rotoextractor or a VISC device is utilized for a more extensive removal. Additionally, this procedure may require the severing of membranes and adhesions to facilitate subtotal removal of the vitreous, ensuring that the surgical goals are met effectively.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 67005 is indicated for various conditions affecting the vitreous humor and may be performed in the following scenarios:

  • Vitreous Hemorrhage - This condition occurs when blood leaks into the vitreous cavity, often due to retinal tears or other ocular trauma, necessitating removal to restore vision.
  • Vitreous Detachment - In cases where the vitreous separates from the retina, partial removal may be required to alleviate symptoms or prevent further complications.
  • Retinal Detachment - When the retina detaches from the underlying tissue, vitreous removal can help facilitate surgical repair and improve outcomes.
  • Macular Hole - The presence of a macular hole may require intervention, and partial vitreous removal can assist in the healing process.

2. Procedure

The procedure for CPT® Code 67005 involves several critical steps to ensure effective partial removal of the vitreous. The following outlines the procedural steps:

  • Step 1: Anesthesia Administration - Prior to the procedure, appropriate anesthesia is administered to ensure patient comfort and minimize pain during the surgery.
  • Step 2: Incision Creation - An incision is made using either the open sky technique, which involves a direct cut in the cornea, or a limbal incision at the junction of the cornea and sclera, providing access to the vitreous cavity.
  • Step 3: Vitreous Strand Cutting - Using a needle or scissors, the surgeon carefully cuts the vitreous strands to facilitate removal. This step is crucial for accessing the areas of concern within the vitreous.
  • Step 4: Suction and Infusion - Once the strands are cut, suction is applied to remove the vitreous gel. Simultaneously, saline is infused to maintain the eye's structure and prevent collapse during the procedure.
  • Step 5: Membrane and Adhesion Management - If necessary, the surgeon may also sever any membranes or adhesions that are present, aiding in the subtotal removal of the vitreous and addressing any underlying issues.
  • Step 6: Closure - After the desired amount of vitreous has been removed, the incision is closed appropriately, ensuring that the eye is stable and ready for recovery.

3. Post-Procedure

Following the procedure associated with CPT® Code 67005, patients typically require monitoring for any immediate complications. Post-operative care may include the use of prescribed eye drops to prevent infection and reduce inflammation. Patients are often advised to avoid strenuous activities and to follow up with their ophthalmologist for ongoing assessment of healing and visual recovery. The expected recovery time can vary based on individual circumstances and the extent of the procedure performed, but patients should be informed about potential symptoms to watch for, such as increased pain, vision changes, or signs of infection.

Short Descr PARTIAL REMOVAL OF EYE FLUID
Medium Descr RMVL VITREOUS ANT APPR PARTIAL REMOVAL
Long Descr Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
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) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P4E - Eye procedure - other
MUE 1
CCS Clinical Classification 20 - Other intraocular therapeutic procedures
RT Right side (used to identify procedures performed on the right side of the body)
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.
LT Left side (used to identify procedures performed on the left side of the body)
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
55 Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number.
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.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
E1 Upper left, eyelid
E2 Lower left, eyelid
E4 Lower right, eyelid
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
SG Ambulatory surgical center (asc) facility service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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