Summary & Overview
CPT 65775: Corneal Wedge Incision to Correct Postsurgical Astigmatism
CPT code 65775 denotes a corneal surgical procedure in which wedges are incised from the cornea to alter corneal curvature and correct astigmatism caused by prior ocular surgery, most commonly after cataract extraction with intraocular lens placement. Nationally, this code represents a targeted ophthalmic intervention to address visual distortions and reduce dependence on corrective lenses following refractive changes induced by other intraocular procedures.
Key payers commonly involved in coverage decisions for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and prior authorization requirements vary by payer and by clinical indications.
Readers will find a concise overview of clinical context and typical sites of service, followed by payment benchmarks, common billing modifiers, and coding crosswalks where available. The publication summarizes payer coverage trends, documentation expectations, and common billing practices relevant to ophthalmology and ambulatory surgical providers. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 65775 describes a surgical procedure in which the provider incises wedges from the cornea to reshape it and correct astigmatism resulting from prior surgery, such as cataract extraction with intraocular lens implantation. This procedure is a corneal refractive technique intended to address surgically induced irregular astigmatism.
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Service type: Corneal surgical procedure to correct postsurgical astigmatism
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Typical site of service: Ophthalmic surgical suite or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old who presents weeks to months after uncomplicated cataract extraction with intraocular lens implantation and reports blurred or distorted vision with refractive astigmatism confirmed on manifest refraction and corneal topography. The ophthalmic surgeon evaluates visual acuity, refraction, slit-lamp exam, and corneal topography to quantify the magnitude and axis of astigmatism attributable to corneal incision or lens position. After conservative management (glasses or contact lens trial) and patient counseling, the provider schedules a procedure to perform limbal relaxing incisions or arcuate keratotomies to change corneal curvature and reduce surgically induced astigmatism. The clinical workflow includes preoperative measurements (keratometry, topography, biometry), informed consent, topical or local anesthesia, creation of precise corneal wedge/incisions (CPT 65775) in the appropriate meridian and depth, intraoperative assessment of incision effect, postoperative topical antibiotics and steroid drops, and follow-up visits for refraction and healing assessment. Typical site of service is an ambulatory surgical center or hospital outpatient department; the service type is an ophthalmic corneal refractive/incisional procedure. Patient documentation includes pre-op refraction and topography, operative report describing incision location/depth and laterality, anesthesia record, and post-op instructions and follow-up notes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 |