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CPT 65400: Corneal Surface Lesion Excision, Superficial
CPT code 65400 represents a surgical procedure for excision of a thin layer from the corneal surface to remove lesions such as masses or scar tissue, excluding pterygium removal. Nationally, this code is relevant for ophthalmology surgical practices, ambulatory surgery centers, and hospital outpatient departments that provide corneal lesion management. It reflects a targeted anterior corneal procedure with implications for coding accuracy, site-of-service designation, and reimbursement for ocular surface surgery.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical context for when CPT code 65400 is used, an explanation of typical settings for the service, and an outline of the administrative elements that affect billing for corneal surface excisions. The publication summarizes common modifiers and administrative considerations when available, and highlights areas where institutions commonly track utilization and authorization needs.
This summary serves clinicians, coding professionals, and policy analysts seeking a concise reference on CPT code 65400, clarifying what the code covers and the national payers typically engaged with claims for this ophthalmic procedure. Data not available in the input.
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Billing Code Overview
CPT code 65400 describes an excision of a thin layer from the surface of the cornea to remove a mass, scar tissue, or other lesion, explicitly excluding removal of a pterygium. This procedure targets the anterior corneal surface that helps focus light onto the lens.
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Service type: Corneal surface excision (superficial corneal lesion removal)
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Typical site of service: Ophthalmology outpatient surgical suite or ambulatory surgery center; may also be performed in hospital outpatient settings when clinically indicated.
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