Summary & Overview
CPT 65771: Corneal Incisional Procedure to Reduce Myopia
CPT code 65771 designates an incisional corneal refractive procedure performed to flatten the cornea and reduce myopia. This surgical code represents a niche but clinically important intervention within ophthalmology and refractive surgery. It matters nationally because it reflects a treatment option for patients seeking correction of nearsightedness when other modalities may be unsuitable or unavailable.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, common sites of service, and the types of information payers typically consider for coverage and claims processing. The publication outlines expected benchmarks for utilization and reimbursement practices where available, highlights relevant policy and coding considerations for national payers, and describes typical documentation elements required to support medical necessity.
The report is designed to help billing and clinical staff understand where CPT code 65771 fits in the spectrum of refractive procedures, what to expect in terms of payer interactions, and which operational and documentation areas warrant attention. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 65771 describes a surgical procedure in which the provider makes small cuts in the cornea to flatten its curvature and reduce myopia. This procedure is an ophthalmic refractive surgery intended to alter corneal shape to decrease nearsightedness.
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Service type: Corneal refractive surgery (incisional keratotomy for myopia)
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Typical site of service: Ambulatory surgery center or hospital outpatient department
Data not available in the input for associated taxonomies and ICD-10 diagnoses.
Clinical & Coding Specifications
Clinical Context
A 28-year-old patient with stable, symptomatic low to moderate myopia seeks a refractive surgical option to reduce dependence on glasses and contact lenses. Preoperative evaluation in the ophthalmology clinic includes manifest and cycloplegic refractions, corneal topography, pachymetry, slit-lamp exam, and dilated fundus exam. The surgeon determines corneal curvature and thickness are suitable for radial keratotomy-style incisional refractive surgery. On the day of service the procedure is performed in an ambulatory surgical center under topical anesthesia with monitored anesthesia care as needed. The provider makes multiple small, calibrated radial incisions in the corneal stroma to flatten the central cornea and reduce myopic refractive error. Postoperative workflow includes topical antibiotic and steroid drops, same-day discharge with activity precautions, and scheduled follow-up visits at 1 day, 1 week, and 1 month to monitor visual acuity, refraction, and wound healing. Billing is coded with 65771 for the incisional procedure to correct myopia; appropriate modifiers are appended for professional component, bilateral procedures, or unusual circumstances when applicable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician's professional component separate from facility technical services. |