Summary & Overview
CPT 65235: Intraocular Foreign Body Removal, Anterior Chamber or Lens
CPT code 65235 denotes surgical removal of an intraocular foreign body located in the anterior chamber or within the lens. This operative ophthalmology procedure is clinically important because retained intraocular foreign bodies can threaten vision, cause inflammation, and lead to infection or other complications if not removed promptly and appropriately. Nationwide, accurate coding of such procedures supports appropriate clinical care pathways, claims adjudication, and aggregate tracking of trauma-related ocular services.
Key payers commonly involved in coverage and claims for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find national-level context on how CPT code 65235 is used, typical sites of service, and the clinical scenario that prompts its use. The publication also summarizes common billing considerations and related service-line implications for surgical ophthalmology.
This content provides clinicians, billing staff, and policy analysts with benchmarks for coding practice, an overview of clinical indications, and a concise reference to support accurate documentation and claims submission. Data not available in the input where specific utilization benchmarks, associated taxonomies, ICD-10 pairings, or payer-specific reimbursement details would normally appear.
Billing Code Overview
CPT code 65235 describes the surgical removal of a foreign body from the eye when the object is located in the anterior chamber or within the lens. This procedure targets intraocular foreign material that cannot be removed externally and requires operative technique to extract the object while preserving ocular structures.
-
Service type: Intraocular foreign body removal (surgical ophthalmic procedure)
-
Typical site of service: Ambulatory surgical center or hospital operating room for ophthalmology procedures
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who presents to the emergency department or outpatient ophthalmology clinic after ocular trauma or with symptoms of a retained intraocular foreign body. The patient reports acute eye pain, decreased visual acuity, photophobia, tearing, or a history of metal-on-metal activity (e.g., grinding) with suspected projectile. Triage includes visual acuity testing, slit-lamp examination, fluorescein staining, and ocular imaging when indicated (plain radiograph, orbital CT, or ocular ultrasound) to localize the foreign body in the anterior chamber or lens. After informed consent and appropriate anesthesia (topical, local block, or monitored anesthesia care), the ophthalmic surgeon performs anterior chamber or intracapsular lens foreign body removal using microsurgical instruments, possibly with capsular repair or lens extraction if the lens is involved. Post-procedure care includes topical antibiotics, anti-inflammatory agents, intraocular pressure monitoring, and scheduled follow-up to assess wound integrity and visual recovery. Typical site of service is an ambulatory surgery center, hospital operating room, or emergency department procedure room depending on acuity and complexity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than typical for 65235 due to complexity or extensive additional procedures documented. |