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The procedure described by CPT® Code 65285 involves the surgical repair of a perforating laceration in the cornea and/or sclera, which are critical components of the eye's structure. A perforating laceration indicates that the injury has penetrated through the full thickness of the cornea or sclera, potentially compromising the integrity of the eye and affecting visual function. The repair process includes the repositioning or resection of uveal tissue, which is the middle layer of the eye that contains important structures such as the iris and ciliary body. The primary objective of this surgical intervention is to achieve a watertight closure of the globe, thereby preventing any leakage of intraocular fluid, restoring the original anatomical configuration of the eye, and preserving or enhancing visual acuity. The procedure is typically performed using conventional sutures, and it requires careful handling of the delicate ocular tissues to minimize complications and ensure optimal healing. The approach begins with addressing the corneal laceration, followed by the scleral repair, and involves meticulous techniques to ensure that the eye's natural curvature is maintained and that no vital structures, such as the iris, are inadvertently trapped during the suturing process.
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The procedure described by CPT® Code 65285 is indicated for the following conditions:
The surgical procedure for CPT® Code 65285 involves several critical steps to ensure effective repair of the laceration:
Post-procedure care following the repair of a perforating corneal and/or scleral laceration is essential for optimal recovery. Patients are typically monitored for signs of infection or complications, and follow-up appointments are scheduled to assess healing. The eye may be covered with a sterile dressing and shield to protect it from external trauma and to minimize movement. Patients may be prescribed topical antibiotics and anti-inflammatory medications to prevent infection and reduce inflammation. It is crucial for patients to adhere to post-operative instructions, including avoiding activities that could strain the eye, such as heavy lifting or vigorous exercise, until cleared by their healthcare provider. Regular follow-up visits will help ensure that the eye is healing properly and that visual function is being restored.
| Short Descr | REPAIR OF EYE WOUND | Medium Descr | RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T | Long Descr | Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue | 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) | 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 | 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 | 19 - Other therapeutic procedures on eyelids, conjunctiva, cornea |
| 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). | 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). | 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. | 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. | 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). | E3 | Upper 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 | 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) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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