Revenue Cycle

August is Cataract Awareness Month: Keep your eyes safe this summer

Coding Educator, August 17, 2009

 By Joe Rivet, CPC, CCS-P, CEMC, CICA

Don't forget the importance of eye health as you enjoy your summer and the outdoor activities that go with it.

Unfortunately, if a person lives long enough, chances are very likely he or she will have some degree of cataract. But it is possible to delay or slow the disease. Wearing proper sunglasses and hats with a brim to block the sunlight is a good start.

The American Academy of Ophthalmology offers these tips to protect your eyes from the sun:

  • Don't focus on the color or darkness of sunglass lenses: Select sunglasses that block UV rays. Don’t be deceived by color or cost. The ability to block UV light is not dependent on the price tag.
  • Check for 100 percent UV protection: Make sure your sunglasses block 100 percent of UV rays and UV-B rays.
  • Choose wrap-around styles: Ideally, your sunglasses should wrap all the way around to your temples, so the sun's rays can't enter from the side.
  • Wear a hat: In addition to your sunglasses, wear a broad-brimmed hat to protect your eyes.
  • Don't rely on contact lenses: Even if you wear contact lenses with UV protection, remember your sunglasses.
  • Don't be fooled by clouds: The sun's rays can pass through haze and thin clouds. Sun damage to eyes can occur anytime during the year, not just in the summertime.
  • Protect your eyes during peak sun times: Sunglasses should be worn whenever you're outside. It's especially important to wear sunglasses in the early afternoon and at higher altitudes, where UV light is more intense.
  • Don't forget the kids: Everyone is at risk, including children. Protect their eyes with hats and sunglasses. In addition, try to keep children out of the sun between 10 a.m. and 2 p.m., when the sun's UV rays are the strongest.

Cataracts are very common in older people; they affect more than half of people 80 years age and older in the United States. Age-related cataracts occur when clumps of protein in the lens of they eye slowly change to a yellowish/brownish color, which affects vision.

Common cataract symptoms include:

  • Blurry vision
  • Colors that appear faded
  • Glare
  • Poor night vision
  • Double vision
  • Frequent prescription changes in your eye wear

Surgery is the typical treatment for cataracts. During the procedure a physician replaces the eye's clouded lens with a clear, artificial lens. The surgery typically takes less than an hour. If both eyes require surgery, the physician usually performs them separately, four to eight weeks apart.

There are three CPT codes that describe cataract surgery:

  • Code 66982: Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (e.g., iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage
  • Code 66983: Intracapsular cataract extraction with insertion of intraocular lens prosthesis (one stage procedures)
  • Code 66984: Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification)

Code selection depends on the method of cataract extraction and complexity, Report codes 66982 or 66984 for extracapsular extraction or code 66983 for intracapsular extraction. For an extracapsular extraction, coders should the code based on whether it is complex (i.e., requiring devices or techniques not generally used in cataract surgery) using code 66982 or not complex, using code 66984.

In terms of diagnosis coding, coders will normally assign one code from the 366.XX series and one code from 367.XX series for refractive services.

Remember that it is common for a patient requiring cataract surgery on both eyes to undergo those surgeries a few weeks apart. Therefore, remember to append modifier -79 (unrelated procedure or service by the same physician during the postoperative period.) when coding for the procedure performed on the second eye. Check with your carrier regarding the necessity of reporting -LT and -RT modifiers as well.

Editor's note: Joe Rivet, CPC, CCS-P, CEMC, CICA, is a regulatory specialist for HCPro, Inc. You can e-mail him at jrivet@hcpro.com.

Most Popular

Related Articles