Summary & Overview
CPT 65779: Amniotic Membrane Placement on Ocular Surface, Sutured
CPT code 65779 denotes the surgical placement of a single layer of amniotic membrane on the ocular surface, secured with sutures. The procedure provides biologic coverage to support healing of the cornea or conjunctiva and is performed when ocular surface stabilization or promotion of epithelialization is clinically indicated. Nationally, this code reflects growing use of biologic grafts in ophthalmic surgery and factors into coverage policies and surgical practice patterns.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines what payers typically consider when evaluating medical necessity for amniotic membrane placement and summarizes common coding and billing contexts for ophthalmology surgical service lines.
Readers will find concise benchmarks for utilization and reimbursement trends, a summary of policy considerations affecting coverage decisions, and the clinical context in which CPT code 65779 is applied. The piece also highlights procedural setting expectations (operating room or ambulatory surgery center) and how the service is documented. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 65779 describes placement of a single layer of amniotic membrane on the ocular surface, applied similarly to a contact lens and secured with sutures. This procedure is used to protect and promote healing of the corneal or conjunctival surface when biologic support is needed.
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Service type: Surgical ocular surface procedure involving graft placement
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Typical site of service: Ophthalmology operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an ophthalmology clinic or ambulatory surgery center with a symptomatic ocular surface disorder such as persistent epithelial defect, nonhealing corneal ulcer, acute chemical or thermal injury, or severe conjunctival scarring. After evaluation by an ophthalmologist or corneal specialist, conservative measures (lubrication, topical antibiotics/antivirals, autologous serum, bandage contact lens) have failed or are insufficient. The provider elects to place a single layer of cryopreserved or dehydrated amniotic membrane onto the ocular surface to promote healing and reduce inflammation.
The clinical workflow includes preoperative consent and topical or regional anesthesia, preparation of the ocular surface, sizing and trimming the amniotic membrane, placement of the membrane over the cornea and/or conjunctiva similar to a contact lens, and securing it with fine sutures. Postprocedure care includes topical medications, patching or shield, scheduled follow-up for suture removal and membrane dissolution assessment, and documentation of indications, technique, and postoperative plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or other outpatient service | Use when the procedure is the primary service performed in an outpatient or ambulatory setting. |