AHA Coding Clinic® for HCPCS - 2019 Quarter 3; For Your Information
Descemet membrane stripping
Patient presents for treatment of combined age related cataract and Fuchs dystrophy in the left eye. The cataract extraction was performed with the use of iris retractors and phacoemulsification was used to remove the cataract in a divide-and-conquer technique with insertion of the lens. Next, Viscoat was injected into the anterior chamber and the cornea was marked with an ossicle bone marker, which encompassed the area of the cornea where the bumps (guttae) formed. The Descemet membrane was stripped (removed) without replacing the corneal endothelium. Viscoat was removed from the anterior chamber via irrigation/aspiration handpiece. CPT code 65756 describes Descemet’s stripping and placement of corneal graft, but providers are not always performing the graft portion. What CPT codes are reported for cataract extraction with Descemet’s stripping when the corneal graft portion of the procedure is not performed? ...
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Article Overview
This premium article focuses on ophthalmic surgical coding for a case involving cataract extraction and Descemet membrane stripping in the setting of Fuchs dystrophy. It is written for coders and billers who need to understand the procedure context, the related CPT framework, and the distinction between the graft-associated code and situations where the graft portion is not performed. The article addresses the relevant procedure components and the coding question raised by the operative scenario.
Why This Topic Matters
Accurate reporting of corneal and cataract procedures depends on understanding what was performed and how it maps to CPT terminology. This article helps coders interpret an operative note that combines cataract surgery with Descemet membrane stripping and clarifies why the case raises a coding question.
What You Will Learn
- How the operative scenario combines cataract surgery with corneal endothelial surgery
- How Descemet membrane stripping is discussed in relation to corneal graft coding
- What coding issue arises when the graft portion is not performed
- How the article frames the question for CPT-based reporting
Who Should Read This
- Medical coders
- Coding auditors
- Ophthalmology billers
- Revenue cycle staff
- Compliance professionals
Codes Discussed
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