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Official Description

Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A mechanical vitrectomy using a pars plana approach is a surgical procedure aimed at addressing various conditions affecting the vitreous humor, which is the gel-like substance filling the center of the eye. This procedure is particularly relevant for patients experiencing complications such as hemorrhage, debris accumulation, scar tissue formation, or retinal tension. The pars plana is a specific area of the eye located between the ciliary body and the retina, where three small incisions are made to facilitate the surgery. During the procedure, a light pipe is utilized to illuminate the interior of the eye, while an infusion port maintains intraocular pressure by replacing the removed vitreous gel with fluid. The vitrectomy device, which operates through microscopic oscillation, carefully extracts the vitreous gel in a controlled manner. Following the removal of the vitreous, the surgical instruments are withdrawn. Additionally, if the procedure includes the repair of the retina, the CPT® Code 67040 is used when panretinal endolaser photocoagulation is performed after the mechanical vitrectomy, allowing for comprehensive treatment of the entire retina.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for various ocular conditions that necessitate the removal of the vitreous gel. These include:

  • Hemorrhage The presence of blood within the vitreous cavity, which can impair vision and may require removal to restore clarity.
  • Debris Removal The extraction of particulate matter or opacities within the vitreous that can obstruct vision.
  • Scar Tissue Removal The elimination of fibrous tissue that may be causing traction on the retina, potentially leading to retinal detachment.
  • Retinal Tension Alleviation Reducing tension on the retina to prevent or treat complications such as retinal tears or detachments.

2. Procedure

The procedure consists of several critical steps that ensure the effective removal of the vitreous gel and, if necessary, the treatment of the retina. These steps include:

  • Step 1: Incision Creation Three tiny incisions are made in the pars plana region of the eye. This area is strategically chosen to minimize trauma to surrounding structures while providing access to the vitreous cavity.
  • Step 2: Instrument Insertion A light pipe, infusion port, and vitrectomy device are inserted through the incisions. The light pipe illuminates the interior of the eye, allowing for better visualization during the procedure.
  • Step 3: Vitrectomy Execution The vitrectomy device is activated, employing a microscopic oscillating cutting mechanism to remove the vitreous gel in a slow and controlled manner. This step is crucial for ensuring that the gel is extracted without damaging surrounding tissues.
  • Step 4: Fluid Replacement As the vitreous gel is removed, fluid is continuously infused through the infusion port to maintain proper intraocular pressure, preventing collapse of the eye structure.
  • Step 5: Instrument Removal Once the vitreous gel has been completely extracted, the surgical instruments are carefully withdrawn from the eye, concluding the mechanical vitrectomy.
  • Step 6: Retina Treatment (if applicable) If panretinal endolaser photocoagulation is indicated, an endoprobe is inserted following the vitrectomy. This device is used to create small focal lesions on the retina, treating the entire retinal surface through photocoagulation.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any complications and ensuring proper recovery. Patients may experience some discomfort or visual disturbances following the surgery. It is essential to follow up with the healthcare provider to assess the healing process and the effectiveness of the procedure. Instructions regarding activity restrictions, medication use, and signs of potential complications should be provided to the patient to ensure a smooth recovery.

Short Descr LASER TREATMENT OF RETINA
Medium Descr VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC
Long Descr Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation
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) 2 - Payment restriction for assistants at surgery does not apply 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 16 - Repair of retinal tear, detachment

This is a primary code that can be used with these additional add-on codes.

66990 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Use of ophthalmic endoscope (List separately in addition to code for primary procedure)
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
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.)
SG Ambulatory surgical center (asc) facility service
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.)
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.
73 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure prior to the administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may cancel a surgical or diagnostic procedure subsequent to the patient's surgical preparation (including sedation when provided, and being taken to the room where the procedure is to be performed), but prior to the administration of anesthesia (local, regional block(s) or general). under these circumstances, the intended service that is prepared for but cancelled can be reported by its usual procedure number and the addition of modifier 73. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
AG Primary physician
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
E1 Upper left, 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
GZ Item or service expected to be denied as not reasonable and necessary
PT Colorectal cancer screening test; converted to diagnostic test or other procedure
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
X3 Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital
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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