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Retinal detachment is a serious ocular condition characterized by the separation of the retina from its underlying supportive tissue, the choroid. This separation can lead to significant visual impairment, including blurred vision, and if not addressed promptly, it may result in permanent blindness. The procedure described by CPT® Code 67101 involves the surgical repair of retinal detachment, which may include the drainage of subretinal fluid when necessary, as well as the application of cryotherapy. During the procedure, a lid speculum is utilized to hold the eyelids open, providing the surgeon with a clear view of the eye. Cryotherapy is a critical component of this repair, where a freezing probe is applied to the outer surface of the eye, specifically through the intact sclera, targeting the area of the retinal detachment. This technique involves creating a series of ice balls around the detachment site, which induces controlled freezing of the tissue. As the frozen area heals, scar tissue forms, effectively anchoring the retina back to the choroid. Additionally, if there is an accumulation of subretinal fluid, the surgeon may perform a drainage procedure by incising the sclera over the elevated retina and puncturing the choroid to allow the fluid to escape. This comprehensive approach aims to restore the normal anatomical position of the retina and preserve vision.
© Copyright 2025 Coding Ahead. All rights reserved.
Retinal detachment repair is indicated for patients presenting with the following conditions:
The procedure for repairing retinal detachment as described by CPT® Code 67101 involves several critical steps:
After the procedure, patients are typically monitored for any immediate complications. Post-operative care may include the use of prescribed eye drops to prevent infection and reduce inflammation. Patients are advised to follow up with their ophthalmologist to assess the success of the repair and monitor for any potential recurrence of detachment. Recovery time may vary, but patients are generally encouraged to avoid strenuous activities and to adhere to any specific instructions provided by their healthcare provider to ensure optimal healing.
| Short Descr | REPAIR DETACHED RETINA CRTX | Medium Descr | RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID CRTX | Long Descr | Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy | Status Code | Active Code | Global Days | 010 - Minor Procedure | 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) | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P4C - Eye procedure - retinal detachment | MUE | 1 | CCS Clinical Classification | 16 - Repair of retinal tear, detachment |
| RT | Right side (used to identify procedures performed on the right 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. | 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. | 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. | 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.) | LT | Left side (used to identify procedures performed on the left side of the body) | SG | Ambulatory surgical center (asc) facility service | 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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| 2017-01-01 | Changed | Long, Medium and Short descriptions changed. |
| 2016-01-01 | Changed | Description Changed |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2009-01-01 | Changed | Code description changed |
| Pre-1990 | Added | Code added. |
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