icd-9 code for anterior capsular phimosis

Full Answer

What is the CPT code for capsular phimosis?

Answer: There is no existing CPT code for capsular phimosis, so report the unlisted CPT code 66999. List the surgical procedure in the narrative box 19, so the payer will know what was performed. If this is a Medicare Part B patient, be sure to obtain a signed ABN and append –GA to CPT code 66999.

What is the pathophysiology of anterior capsule fibrosis and Phimosis?

Disease. Anterior capsule fibrosis and phimosis is a condition that can occur after phacoemulsification and intraocular lens (IOL) implantation whereby the anterior capsulotomy excessively contracts and fibroses potentially obstructing the visual axis or causing late secondary complications to the IOL such as pseudophacodonesis and IOL tilt,...

What is the CPT code for anterior capsulotomy?

If this is a Medicare Part B patient, be sure to obtain a signed ABN and append –GA to CPT code 66999. For commercial plans, you should preauthorize for anterior capsulotomy. This will not guarantee payment, however; the patient may be responsible for payment.

What is anterior capsule contraction syndrome (ACCS)?

by Derek W DelMonte, MD on July 21, 2021. Anterior capsule fibrosis and phimosis, commonly described as anterior capsule contraction syndrome (ACCS), is the centripetal constriction and fibrosis of the capsulorhexis following cataract removal.

What is anterior capsule phimosis?

Anterior capsule fibrosis and phimosis, commonly described as anterior capsule contraction syndrome (ACCS), is the centripetal constriction and fibrosis of the capsulorhexis following cataract removal.

What is the ICD-10 code for anterior capsular phimosis?

N47. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM N47.

What is anterior capsule opacification?

Anterior Capsule Opacification (ACO) 2A). This is pronounced in eyes in which a continuous curvilinear capsular opening overlaps the IOL edge and peripheral anterior IOL surface (5, 6). This opacification sets in by the first postoperative month and continues until 6 months (7).

What is the ICD-10 CM code for phimosis?

ICD-10 code N47. 1 for Phimosis is a medical classification as listed by WHO under the range - Diseases of the genitourinary system .

What is anterior capsular cataract?

Anterior subcapsular cataracts (ASC) form after anterior lens epithelial cells become necrotic from a variety of causes including iritis, keratitis, inflammation associated with atopic dermatitis, irradiation, or electrical burns.

What is the meaning of capsulotomy?

A capsulotomy is a surgical procedure used to treat posterior calcium opacification or PCO, a complication caused by cataract extraction surgery.

What is the appropriate diagnosis code for posterior capsular opacity?

Coding professionals believe this is a secondary cataract and a code from category H26. 4- is appropriate.

What is a posterior capsule?

Structurally, the posterior capsule is very simple: a clear, elastic, membrane-like collagen structure synthesized by the lens epithelial cells to encapsulate the lens fibers. Functionally, however, it forms a crucial barrier between the anterior and posterior segments, both anatomically and physiologically.

What causes PCO after cataract surgery?

PCO occurs because cells remaining after cataract surgery grow over the back (posterior) of the capsule causing it to thicken and become slightly opaque (cloudy). This means that light is less able to travel through to the retina at the back of your eye.

What is the difference between phimosis and Paraphimosis?

Phimosis is when a foreskin can't be pulled down (retracted) from the tip of the penis. This is a common problem in young boys. Paraphimosis is when the foreskin is retracted but can't move back up. This can prevent normal blood flow in the penis, and may cause serious problems.

What is the CPT code for phimosis?

CPT® 54450, Under Manipulation Procedures on the Penis.

Is phimosis a congenital condition?

The condition known as congenital phimosis, a contraction of the prepuce over the glans penis attended by inability of retraction, has of late called the attention of the profession to the fact of its very frequent occurrence, and being a source of discomfort and suffering and evil to the young victim.

Known As

Phimosis is also known as adherent prepuce, adherent prepuce of newborn, adherent prepuce newborn, excessive foreskin after circumcision, hypertrophy of the male prepuce, iatrogenic and secondary phimosis, iatrogenic and secondary physmosis, male hypertrophic prepuce, paraphimosis, phimosis, phimosis (tight foreskin), redundant foreskin, redundant prepuce, redundant prepuce w phimosis, redundant prepuce with phimosis, tight foreskin, tight frenulum of foreskin, tight frenulum of prepuce, and tight frenulum of prepuce of penis.

Phimosis Definition and Symptoms

Phimosis is a condition that makes it extremely painful to retract the foreskin of the penis. This occurs in boys and men that are not circumcised. This condition typically resolves itself by the age of three. Symptoms include swelling of the tip of the penis, discoloration, and the inability to pull foreskin over the tip of the penis.

What is the treatment for phimosis without invasion of optical zone?

In less severe phimosis without invasion of the optical zone, the first choice of treatment is neodymium:YAG (Nd:YAG) laser capsulotomy while manually peeling of the fibrotic membrane is the technique of choice in severe cases with dense fibrous plaques to prevent incomplete reabsorption of loose capsular debris and to decrease the risk of inflammation and recurrence.

What is a curvilinear capsulorhexis?

Continuous curvilinear capsulorhexis openings created in cataract surgery are known to contract slightly in non-pathologic eyes. Anterior capsule fibrosis and phimosis is a condition that can occur after phacoemulsification and intraocular lens (IOL) implantation whereby the anterior capsulotomy excessively contracts and fibroses potentially obstructing the visual axis or causing late secondary complications to the IOL such as pseudophacodonesis and IOL tilt, decentration, or dislocation due to zonular laxity, weakness or dehiscence.

How long does it take for visual acuity to decrease in ACCS?

The onset of decreased visual acuity in ACCS patients can range from 2 weeks to more than 3 months. Capsule shrinkage and closure involves contraction of the fibrous membrane following fibrous metaplasia of LECs as well as LEC proliferation and outgrowth from the anterior capsule margin onto the IOL toward the center of the capsular opening, likely mediated by LEC cytokine signaling.

Can you cut out an annulus of capsule?

Some surgeons have tried cutting out an annulus of capsule using the LASER, but it is not recommended as it deposits in the angle and often leads to raised intraocular pressure. We recommend that this be accomplished when phimosis has progressed to less than 4mm to prevent potential late zonular dehiscence.