Crystal's MCW Coder Hub🩺 CPT 67108 — Repair of Retinal Detachment with Vitrectomy
Code Description
CPT 67108 describes the surgical repair of a rhegmatogenous, tractional, or combined rhegmatogenous-tractional retinal detachment using pars plana vitrectomy (PPV) as the primary operative approach. This is one of the most comprehensive and technically complex codes in the ophthalmology surgery section and encompasses a broad range of intraoperative adjunctive techniques that may be performed in combination during the same operative session.
The full descriptor reads: Repair of retinal detachment; with vitrectomy, any method, with or without air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens.
The phrase “with or without” is critically important — it means that all of the listed adjunctive procedures (air/gas tamponade, endolaser, cryotherapy, subretinal fluid drainage, scleral buckling, lens removal) are bundled into CPT 67108 when performed at the same operative session as the vitrectomy for retinal detachment repair. These components cannot be unbundled and reported separately.
Pars plana vitrectomy for retinal detachment involves the removal of vitreous gel from the posterior segment of the eye through small-gauge sclerotomies placed in the pars plana (typically 23-gauge, 25-gauge, or 27-gauge systems). The vitreous is removed using a vitreous cutter under direct visualization via a wide-field viewing system. Retinal breaks, tears, or holes are identified and treated, the retina is flattened using fluid-air exchange or perfluorocarbon liquid (PFCL), and the break is sealed with laser photocoagulation or cryotherapy. Tamponade is achieved with air, expansile gas (C3F8, C2F6, SF6), or silicone oil to maintain retinal apposition during healing.
Procedure Overview
Indications
CPT 67108 is indicated for the surgical repair of retinal detachments that require vitrectomy as the operative method. Common clinical scenarios include:
- Rhegmatogenous retinal detachment (RRD) — caused by a full-thickness break in the retina allowing liquefied vitreous to enter the subretinal space; the most common type
- Complex or posterior RRD — posterior tears or breaks, macular-involving detachments, or detachments not amenable to scleral buckle alone
- Tractional retinal detachment (TRD) — caused by fibrovascular proliferative membranes pulling the retina away from the RPE, commonly seen in proliferative diabetic retinopathy (PDR)
- Combined tractional-rhegmatogenous retinal detachment — mixed mechanism detachments, often in diabetic patients
- Retinal detachment with proliferative vitreoretinopathy (PVR) — failed prior detachment repair with membrane formation requiring membrane peeling and vitrectomy
- Giant retinal tear (GRT) — tears extending 90 degrees or more of circumference
- Posterior break retinal detachment — detachment secondary to a macular hole or posterior pole break
Operative Steps
- Informed consent and pre-operative marking of the operative eye
- Anesthesia induction (general or MAC with retrobulbar/peribulbar block)
- Preparation and draping of the periocular field
- Conjunctival peritomy and placement of infusion cannula (typically inferotemporal)
- Placement of two additional sclerotomy ports for the light pipe and vitreous cutter
- Core vitrectomy — removal of central vitreous
- Peripheral vitrectomy — shaving of the vitreous base, relief of vitreoretinal traction
- Identification of all retinal breaks, tears, and areas of lattice degeneration
- Subretinal fluid drainage (internal or external) as needed
- Fluid-air exchange (FAX) or injection of perfluorocarbon liquid (PFCL) to flatten the retina
- Endolaser photocoagulation around all breaks and tears (focal or scatter)
- Cryotherapy (if applicable, typically for anterior breaks or as an alternative to laser)
- Injection of tamponade agent — expansile gas (SF6, C2F6, C3F8) or silicone oil (1000 cs or 5000 cs)
- Sclerotomy closure (suture or self-sealing depending on gauge)
- Conjunctival closure and subconjunctival injection of antibiotic/steroid
Includes (Bundled — Do Not Report Separately)
The following procedures are explicitly bundled into CPT 67108 by CPT definition and NCCI (National Correct Coding Initiative) edits when performed at the same operative session for retinal detachment repair:
- Pars plana vitrectomy (PPV) — any gauge (20g, 23g, 25g, 27g)
- Air or gas tamponade — including SF6, C2F6, C3F8 expansile gases
- Silicone oil injection as tamponade
- Focal endolaser photocoagulation — endoscopic or indirect laser delivery to retinal breaks
- Cryotherapy — transscleral cryoretinopexy for break treatment
- Drainage of subretinal fluid (SRF) — internal or external drainage
- Scleral buckling — if performed at the same session (segmental or encircling buckle)
- Lens removal — if lensectomy or phacoemulsification is required to access the retina (lentectomy for vitreous access)
- Fluid-air exchange (FAX)
- Perfluorocarbon liquid (PFCL) injection for retinal flattening
- Membrane peeling — internal limiting membrane (ILM) peeling or epiretinal membrane (ERM) peeling if performed during the same session for the purpose of retinal detachment repair
- Infusion cannula placement
- Sclerotomy creation and closure
Excludes / Report Separately
- Silicone oil removal at a subsequent encounter — CPT 67121 (removal of implanted material from posterior segment; intravitreal) — reported at a separate operative session
- Strabismus repair — if performed at a truly separate operative encounter
- Cataract surgery (phacoemulsification with IOL) at a separate session — CPT 66982 or 66984; however, if phaco-vitrectomy is performed at the SAME session for retinal detachment repair, the lens removal is bundled into 67108
- Pars plana vitrectomy for indications OTHER than retinal detachment (e.g., vitreous hemorrhage without retinal detachment, dropped nucleus, retained lens fragment, endophthalmitis, macular hole) — these are reported under different CPT codes such as 67036, 67039, 67040, or 67041
- Retinal photocoagulation at a SEPARATE session — CPT 67210 (destruction of localized lesion, photocoagulation, one or more sessions) or CPT 67228 (panretinal photocoagulation)
- Intravitreal injection of pharmacologic agent at a subsequent session — CPT 67028
- Posterior vitreous cortex removal (membrane peeling) at a separate session — CPT 67041 or 67042
- Scleral buckling ALONE without vitrectomy — CPT 67107
Code Tree — Retinal Detachment Repair CPT Codes
| CPT Code | Description |
|---|---|
| 67101 | Repair of retinal detachment; cryotherapy or diathermy, with or without drainage of subretinal fluid |
| 67105 | Repair of retinal detachment; photocoagulation, one or more sessions |
| 67107 | Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), with or without implant, with or without cryotherapy, photocoagulation, and/or drainage of subretinal fluid |
| 67108 | Repair of retinal detachment; with vitrectomy, any method, with or without air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens — this code |
| 67110 | Repair of retinal detachment; by injection of air or other gas (e.g., pneumatic retinopexy) |
| 67113 | Repair of complex retinal detachment (e.g., proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinoschisis, retinal or choroidal coloboma, etc.) with vitrectomy and, if performed, vitreous substitutes (e.g., air, gas, or silicone oil), cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens |
| 67121 | Removal of implanted material from posterior segment; intravitreal (silicone oil removal) |
| 67141 | Prophylaxis of retinal detachment; cryotherapy, diathermy — without drainage |
| 67145 | Prophylaxis of retinal detachment; photocoagulation — without drainage |
Key Distinction — 67108 vs. 67113: CPT 67108 applies to standard vitrectomy-based retinal detachment repair. CPT 67113 is reserved for complex retinal detachments with specific qualifying conditions including: proliferative vitreoretinopathy (PVR) Stage C-1 or greater, diabetic tractional retinal detachment, retinopathy of prematurity (ROP), retinoschisis with detachment, retinal or choroidal coloboma with detachment, or other complex pathology requiring advanced techniques such as membrane peeling, relaxing retinotomies, or retinectomy. CPT 67113 carries a higher wRVU (approximately 31.52) and requires explicit documentation of the complex pathology in the operative report. Do not upcode from 67108 to 67113 without clear documentation of a qualifying complex condition.
Key Distinction — 67108 vs. 67107: CPT 67107 (scleral buckling alone) is appropriate when the surgeon does not enter the eye to perform vitrectomy. If vitrectomy is performed IN ADDITION to scleral buckling, the entire procedure is captured under 67108 — the scleral buckle component is bundled and 67107 is not reported separately.
Key Distinction — 67108 vs. 67036: CPT 67036 (vitrectomy, mechanical, pars plana approach) is used for vitrectomy performed for indications other than retinal detachment repair (e.g., vitreous hemorrhage without detachment, vitreous opacities, floaters). When vitrectomy is performed specifically for retinal detachment repair, use 67108 regardless of whether the detachment is fresh or chronic.
ICD-10-CM Diagnosis Codes
Primary Diagnoses — Retinal Detachment
| ICD-10-CM | Description | Laterality |
|---|---|---|
| H33.001 | Unspecified retinal detachment with retinal break, right eye | Right |
| H31.402 | Unspecified retinal detachment with retinal break, left eye | Left |
| H33.003 | Unspecified retinal detachment with retinal break, bilateral | Bilateral |
| H33.011 | Retinal detachment with single break, right eye | Right |
| H33.012 | Retinal detachment with single break, left eye | Left |
| H33.021 | Retinal detachment with multiple breaks, right eye | Right |
| H33.022 | Retinal detachment with multiple breaks, left eye | Left |
| H33.031 | Retinal detachment with giant retinal tear, right eye | Right |
| H33.032 | Retinal detachment with giant retinal tear, left eye | Left |
| H33.041 | Retinal detachment with retinal dialysis, right eye | Right |
| H33.042 | Retinal detachment with retinal dialysis, left eye | Left |
| H33.051 | Total retinal detachment, right eye | Right |
| H33.052 | Total retinal detachment, left eye | Left |
| H33.20 | Serous retinal detachment, unspecified eye | Unspecified |
| H33.21 | Serous retinal detachment, right eye | Right |
| H33.22 | Serous retinal detachment, left eye | Left |
| H33.40 | Traction detachment of retina, unspecified eye | Unspecified |
| H33.41 | Traction detachment of retina, right eye | Right |
| H33.42 | Traction detachment of retina, left eye | Left |
Associated / Secondary Diagnoses
| ICD-10-CM | Description |
|---|---|
| E11.351 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye |
| E11.352 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye |
| E11.353 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye |
| E11.354 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye |
| H33.11 | Retinoschisis, right eye |
| H33.12 | Retinoschisis, left eye |
| H35.371 | Proliferative vitreo-retinopathy with retinal detachment, right eye |
| H35.372 | Proliferative vitreo-retinopathy with retinal detachment, left eye |
| H44.001 | Unspecified purulent endophthalmitis, right eye (if combined surgery) |
| Z96.1 | Presence of intraocular lens (pseudophakic patient) |
| Z79.01 | Long-term (current) use of anticoagulants (relevant for surgical planning) |
Laterality Requirement: ICD-10-CM requires laterality for all retinal detachment codes. Unspecified laterality (e.g., H33.00, H33.009) should only be used when the operative/clinical documentation genuinely does not specify which eye was treated, which is rare in surgical cases. Always assign the laterality-specific code when documented.
Diabetic Retinal Detachment: When a retinal detachment is the direct result of diabetic tractional forces in a patient with diabetes mellitus, the diabetic retinopathy code from the E10-E13 category (e.g., E11.351-E11.354) captures both the underlying disease and the retinal detachment manifestation. In these cases, the E11.35x code is preferred as the principal diagnosis over H33.4x, as it provides greater clinical specificity. Query the documentation and type of diabetes carefully.
HCC Relevance
CPT 67108 itself is a CPT procedure code and does not have a direct HCC assignment. However, the associated diagnosis codes have significant HCC implications:
| ICD-10-CM | HCC Category | RAF Weight Significance |
|---|---|---|
| E11.351-E11.354 | HCC 18 (Diabetes with Chronic Complications) | High — diabetic retinal detachment |
| E10.351-E10.354 | HCC 18 (Diabetes with Chronic Complications) | High — Type 1 diabetic retinal detachment |
| H33.001-H33.052 | No direct HCC | Not HCC-mapped |
| H35.371-H35.372 | No direct HCC | Not HCC-mapped |
HCC Coding Note:
Retinal detachment itself (H33.x) is not an HCC-mapped condition under CMS-HCC v24 or v28. However, when retinal detachment is a complication of diabetic proliferative retinopathy, the diabetic eye disease codes (E11.351-E11.359, E10.351-E10.359, etc.) map to HCC 18 and carry meaningful RAF weight. It is essential to capture the underlying diabetic etiology with full specificity to ensure appropriate risk adjustment. Additionally, if the patient carries diagnoses of blindness or low vision (H54.x) secondary to retinal disease, these may map to HCC 124 and should be coded when documented.
wRVU and Reimbursement
| Metric | Value |
|---|---|
| Work RVU (wRVU) | 23.68 |
| Total RVU (facility, national avg) | ~32.00 |
| Total RVU (non-facility/ASC) | ~45.00+ |
| Global Period | 90 days |
| Assistant Surgeon Payable | Yes — modifier -80, -82, or -AS |
| Co-Surgeon | Generally not applicable |
| Bilateral | Not applicable under a single CPT; report second eye separately |
| Modifier -50 | Not applicable; bilateral eye surgery reported with modifier -RT and -LT or as separate line items |
| Teaching Physician | Modifier -GC applicable in academic/teaching settings |
| Anesthesia CPT | 00147 (anesthesia for intraocular procedures) |
Assistant Payable Detail: ****
CPT 67108 is generally payable with an assistant surgeon. Complex vitreoretinal cases — particularly those involving giant retinal tears, PVR, or combined phaco-vitrectomy — often require or benefit from an assistant for scleral depression, chandelier light placement, or management of instruments during fluid-air exchange. Medicare and most commercial payers recognize assistant surgeon payability for this code. When an ophthalmic resident or fellow assists in a teaching setting, the teaching physician rules apply and modifier -GC must be appended to the supervising surgeon’s claim.
ASC vs. Hospital Outpatient:
The vast majority of retinal detachment surgeries using CPT 67108 are performed in an Ambulatory Surgery Center (ASC) or hospital outpatient setting. Inpatient admission for retinal detachment repair is uncommon but may occur in patients with significant systemic comorbidities, bilateral simultaneous surgery, or those requiring post-operative positioning monitoring in a supervised setting.
MS-DRG Assignment
Retinal detachment repair is predominantly performed in the outpatient or ASC setting. Inpatient admission is uncommon but may occur in medically complex patients. When billed inpatient, the MS-DRG is determined by the principal diagnosis and the presence of CC/MCC conditions.
| MS-DRG | Description | Type |
|---|---|---|
| 124 | Other Disorders of the Eye with MCC | Medical |
| 125 | Other Disorders of the Eye without MCC | Medical |
| 116 | Intraocular Procedures with CC/MCC | Surgical |
| 117 | Intraocular Procedures without CC/MCC | Surgical |
MS-DRG Coding Note:
When an inpatient retinal detachment repair is performed, the ICD-10-PCS procedure code drives DRG assignment to the surgical DRGs (116-117) rather than the medical DRGs (124-125). Accurate ICD-10-PCS coding is essential to ensure the claim is classified as a surgical DRG, which carries higher relative weight and reimbursement. The presence of MCC conditions such as uncontrolled diabetes (E11.649), sepsis, or other major systemic disease will impact DRG weight significantly.
ICD-10-PCS Equivalents (Inpatient Facility Coding)
For inpatient cases, the following ICD-10-PCS codes are used to capture the components of pars plana vitrectomy-based retinal detachment repair. Multiple codes are typically required to fully represent the procedure.
| ICD-10-PCS Code | Description |
|---|---|
| 08JK3ZZ | Inspection of Right Vitreous, Percutaneous Approach |
| 08JL3ZZ | Inspection of Left Vitreous, Percutaneous Approach |
| 08RK3JZ | Replacement of Right Retina with Synthetic Substitute, Perc Approach (not standard — use resection/repair codes) |
| 08C53ZZ | Extirpation of Matter from Right Vitreous, Percutaneous Approach (vitrectomy, right) |
| 08C63ZZ | Extirpation of Matter from Left Vitreous, Percutaneous Approach (vitrectomy, left) |
| 08QK3ZZ | Repair of Right Retina, Percutaneous Approach |
| 08QL3ZZ | Repair of Left Retina, Percutaneous Approach |
| 08VK3CZ | Restriction of Right Retinal Vessel with Extraluminal Device, Perc Approach |
| 08NK3ZZ | Release of Right Retina, Percutaneous Approach (membrane peeling) |
| 08NL3ZZ | Release of Left Retina, Percutaneous Approach (membrane peeling) |
ICD-10-PCS Note:
The percutaneous approach (character 3) is used for pars plana vitrectomy, as the instruments enter through small-gauge sclerotomies rather than a formal open incision. The primary root operation for vitreous removal is Extirpation (C) — taking or cutting out solid matter from a body part — which best captures the mechanical removal of vitreous gel. Retinal repair is captured with the Repair (Q) root operation. If membrane peeling (ILM or ERM) is performed, the Release (N) root operation is appropriate. As always, confirm current-year ICD-10-PCS tables in your encoder for exact code validity.
Coding Examples
Example 1 — Standard Rhegmatogenous Retinal Detachment Repair, Right Eye
A 54-year-old male presents with a macula-off rhegmatogenous retinal detachment of the right eye with multiple breaks at 10 o’clock and 2 o’clock. He undergoes 25-gauge pars plana vitrectomy with fluid-air exchange, endolaser photocoagulation around all breaks, and C3F8 gas tamponade. No scleral buckle is placed.
CPT Code:
- 67108-RT — Repair of retinal detachment with vitrectomy, right eye
ICD-10-CM:
- H33.021 — Retinal detachment with multiple breaks, right eye
ICD-10-PCS (Inpatient):
- 08C53ZZ — Extirpation of Matter from Right Vitreous, Percutaneous Approach
- 08QK3ZZ — Repair of Right Retina, Percutaneous Approach
Example 2 — Vitrectomy with Scleral Buckle for Inferior Retinal Detachment, Left Eye
A 61-year-old female with high myopia presents with an inferior rhegmatogenous retinal detachment of the left eye with a dialysis at the ora serrata. The surgeon performs 23-gauge pars plana vitrectomy, places a 240 encircling silicone band scleral buckle, performs cryotherapy to the dialysis, drains subretinal fluid, and performs a fluid-air exchange with SF6 gas tamponade.
CPT Code:
- 67108-LT — Repair of retinal detachment with vitrectomy (scleral buckle, cryotherapy, SRF drainage, and gas tamponade are ALL bundled)
ICD-10-CM:
- H33.041 — Retinal detachment with retinal dialysis, left eye (note: left eye is 042 — confirm laterality)
- H33.042 — Retinal detachment with retinal dialysis, left eye
Do NOT separately report: 67107 (scleral buckle), 67101 (cryotherapy), or any additional retinal detachment repair code. All are bundled into 67108.
Example 3 — Combined Phacoemulsification and Vitrectomy for Retinal Detachment (Phaco-Vitrectomy)
A 70-year-old pseudophakic male with a dense posterior capsule opacity and a superior macula-on retinal detachment with a large horseshoe tear undergoes combined cataract extraction with IOL implantation and pars plana vitrectomy with endolaser and C2F6 gas in the same operative session.
CPT Codes:
- 67108-RT — Vitrectomy for retinal detachment repair (principal procedure)
- 66982-RT-51 or 66984-RT-51 — Complex or routine cataract extraction with IOL, same session
Coding Controversy Note: There is ongoing payer variability regarding whether cataract extraction (66982/66984) can be separately reported when performed at the same session as vitrectomy for retinal detachment. Some payers bundle the lens removal into 67108 based on the "removal of lens" language in the descriptor. Review payer-specific policies carefully. When the cataract surgery is performed as a distinct, medically necessary procedure (e.g., the cataract itself is visually significant and would have been scheduled independently), separate reporting may be supported with documentation. Use modifier -51 (multiple procedures) on the secondary procedure and include a strong operative note justifying the separate procedure.
Example 4 — Tractional Retinal Detachment from Proliferative Diabetic Retinopathy
A 58-year-old male with Type 2 diabetes mellitus and proliferative diabetic retinopathy presents with a tractional retinal detachment involving the macula of the right eye. He undergoes 25-gauge pars plana vitrectomy with membranectomy, delamination of fibrovascular membranes, endolaser panretinal photocoagulation, and silicone oil tamponade.
CPT Code:
- 67108-RT — if the detachment is straightforward tractional without PVR or other complex features
- OR 67113-RT — if PVR Stage C-1 or greater is documented, or the diabetic TRD meets the complexity threshold
ICD-10-CM:
- E11.351 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
Documentation Query Point: The distinction between 67108 and 67113 for diabetic tractional retinal detachment is significant (difference of approximately 8 wRVU). CPT 67113 explicitly lists “diabetic traction retinal detachment” as a qualifying complex condition. If the operative report documents a diabetic tractional retinal detachment with vitrectomy and membrane delamination, 67113 may be the appropriate code. Always review the full operative report and consider a surgeon query if the complexity level is not explicitly stated.
Example 5 — Pneumatic Retinopexy vs. Vitrectomy — Incorrect Code Selection Scenario
A 45-year-old female presents with a superior single-break rhegmatogenous retinal detachment. The surgeon performs an in-office procedure: cryotherapy to the break followed by intravitreal injection of C3F8 gas (pneumatic retinopexy). No vitrectomy is performed.
Incorrect: 67108 (vitrectomy — no vitrectomy was performed) Correct: 67110 — Repair of retinal detachment by injection of air or other gas (pneumatic retinopexy)
Coder Note: CPT 67108 requires that vitrectomy be the operative method. Pneumatic retinopexy (67110) is an in-office or minor procedure setting technique that does not involve entering the vitreous cavity with a vitreous cutter. These are distinct procedures with different CPT codes, different wRVUs, and different facility requirements.
Documentation Requirements
To support CPT 67108, the operative report must include:
- Diagnosis — explicit documentation of the type of retinal detachment (rhegmatogenous, tractional, combined), laterality, macular status (on vs. off), and extent of detachment
- Operative approach — pars plana vitrectomy must be explicitly performed and documented; gauge of instrumentation (20g, 23g, 25g, 27g) should be noted
- Adjunctive procedures performed — documentation of which bundled components were performed (endolaser, cryotherapy, gas tamponade, oil, buckle, SRF drainage) even though they are not separately billed
- Tamponade agent used — type of gas (SF6, C2F6, C3F8) and concentration, or silicone oil viscosity (1000 cs vs. 5000 cs)
- Retinal break identification — location (clock hours), type (horseshoe tear, round hole, dialysis, giant tear), and treatment of all breaks
- Macular status — whether the macula was attached or detached at the time of surgery (affects urgency, prognosis, and sometimes coding)
- Patient positioning instructions — post-operative positioning (face down, prone, lateral) is medically relevant and should be documented
- Complexity factors — if billing 67113, explicit documentation of PVR stage, diabetic TRD, GRT, or other qualifying complex feature is mandatory
Clinical Notes for Coders
- Silicone oil as tamponade does not trigger a separate CPT code when placed at the time of retinal detachment repair — it is bundled into 67108. However, silicone oil removal at a SUBSEQUENT surgical encounter is separately reportable as CPT 67121.
- ILM peeling performed during vitrectomy for a macular hole (without detachment) is reported under CPT 67042. When ILM or ERM peeling is performed during vitrectomy specifically for retinal detachment repair (e.g., to relieve tractional forces in PVR), it is bundled into 67108 or 67113.
- Chandelier light placement for wide-field illumination during complex vitrectomy is not separately reportable.
- Perfluorocarbon liquid (PFCL) used intraoperatively for retinal flattening is a surgical supply and is not separately reportable by the surgeon; it may be captured by the facility as a supply charge.
- Postoperative visits during the 90-day global period are included in the surgical package. Visits for complications, unrelated conditions, or critical care during the global period may have specific reporting rules — consult the global surgery policy.
- Same-day bilateral retinal detachment surgery is exceedingly rare and medically unusual. If performed, report each eye separately with appropriate laterality modifiers (-RT and -LT), and be prepared for payer scrutiny.
- Retinal detachment prophylaxis (treatment of retinal tears or lattice degeneration WITHOUT detachment) is reported with CPT 67141 (cryotherapy) or CPT 67145 (photocoagulation), NOT with CPT 67108.
- Modifier -78 (unplanned return to the operating room during the global period) should be appended if the patient requires a return to the OR for a complication such as re-detachment or vitreous hemorrhage during the 90-day post-operative period.
- Modifier -58 (staged or related procedure during the global period) is appropriate if silicone oil removal (67121) or a planned second-stage procedure is performed during the global period of the initial repair.