© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 67025 involves the injection of a vitreous substitute into the eye, specifically through a pars plana or limbal approach. The vitreous humor is a gel-like substance that fills the space behind the lens of the eye and is crucial for maintaining the shape of the eyeball and supporting the retina. As individuals age, this gel-like substance can become more fluid, and it may be lost due to various factors such as eye injuries or surgical procedures like vitrectomy. When the vitreous humor is compromised, it is essential to replace it with a vitreous substitute to alleviate any traction on the retina, which can help facilitate the healing process and allow for scar formation. During the procedure, the eye is prepared with anesthetic drops to minimize discomfort, and an antibacterial solution is applied to cleanse the surface of the eye. The physician identifies and marks a specific injection site in the pars plana or limbus area, which is critical for accessing the posterior segment of the eye. A small-gauge needle connected to a syringe filled with the vitreous substitute is then carefully inserted into the eye at the marked site. The vitreous substitute, which may consist of various substances such as gas (e.g., sulfur hexafluoride or n-perfluoropropane), air, or oil (e.g., polydimethylsiloxane), is injected to replace the lost vitreous humor. After the injection, the needle is withdrawn, and pressure is applied to the puncture site using a cotton-tipped applicator to prevent fluid leakage. Finally, antibiotic eye drops may be administered to reduce the risk of infection following the procedure.
© Copyright 2025 Coding Ahead. All rights reserved.
The injection of a vitreous substitute using CPT® Code 67025 is indicated for various conditions that result in the loss or compromise of the vitreous humor. These indications include:
The procedure for injecting a vitreous substitute involves several critical steps to ensure safety and effectiveness. Each step is designed to prepare the eye, administer the substitute, and manage the post-injection care.
After the injection of the vitreous substitute, patients are typically monitored for any immediate complications, such as fluid leakage or signs of infection. It is essential to follow any post-procedure care instructions provided by the physician, which may include the use of prescribed antibiotic eye drops and recommendations for activity restrictions. Patients may experience some discomfort or changes in vision following the procedure, which should be discussed with their healthcare provider. Follow-up appointments are crucial to assess the effectiveness of the injection and to monitor the health of the retina and overall eye condition.
| Short Descr | REPLACE EYE FLUID | Medium Descr | INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX | Long Descr | Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) | 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) | 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). | 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). | 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. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 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 | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | SG | Ambulatory surgical center (asc) facility service | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2008-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.