OPHTHALMOLOGY: No More Unlisted Code For Lucentis Next Year

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This premium article explains forthcoming coding changes relevant to ophthalmology, especially retina surgery and related treatment/reporting updates. It is aimed at coders and billing staff who work with retinal procedures, pediatric retinopathy services, tear duct procedures, and specialty drug coding. The article covers new and revised CPT and HCPCS Level II entries, along with the documentation and reference resources readers should review for the transition.

Why This Topic Matters

The article helps ophthalmology billing teams identify which upcoming code changes may affect their workflow, documentation review, and claims processing for retinal procedures and drug supply reporting.

Article Sections

  1. Prepare to specify your doctor's approach to retina surgery

    Introduces upcoming ophthalmology coding changes tied to retina surgery and related procedure reporting. It frames the article around CPT and HCPCS updates taking effect in the new year.

  2. Anticipate New Retinal Detachment Code

    Covers additional CPT updates related to retinal detachment and other ophthalmic procedure additions. It also notes a descriptor change for an existing retinopathy treatment code and a new HCPCS drug coding update.

What You Will Learn

  • The broad types of ophthalmology coding changes scheduled for the new year
  • Which general areas of retina surgery reporting are affected by CPT updates
  • What categories of ophthalmic procedures receive new or revised codes
  • How specialty drug reporting changes under HCPCS Level II are being introduced
  • Which reference resources coders should consult when preparing for the updates

Who Should Read This

  • Ophthalmology coders
  • Medical billers
  • Retina practice staff
  • Revenue cycle professionals
  • Physician documentation teams

Codes Discussed

  • CPT: 67038
  • CPT: 67041
  • CPT: 67042
  • CPT: 67043
  • CPT: 67113
  • CPT: 68816
  • CPT: 67729
  • CPT: 67228
  • HCPCS Level II: J3490
  • HCPCS Level II: J3590

Code Ranges Discussed

  • CPT: 67041-67043

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