CPT 65782 Limbal Conjunctival Autograft Reimbursement | OpenPayer

Summary & Overview

CPT 65782: Limbal Conjunctival Autograft for Ocular Surface Reconstruction

CPT code 65782 covers limbal conjunctival autograft transplantation, a surgical eye reconstruction in which tissue from one of a patient’s eyes is used to repair the ocular surface of the other eye after injury or disease. This procedure preserves corneal and conjunctival integrity, prevents progressive surface failure, and can reduce long-term visual morbidity. Nationally, this code is relevant to ophthalmic surgical practices, ambulatory surgery centers, and hospital outpatient departments that provide complex anterior segment reconstruction. Key payers typically involved in coverage and payment for this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find concise clinical and billing context for CPT code 65782, including the clinical purpose of the procedure, typical sites of service, and what to expect in terms of where the procedure is performed. The publication also outlines benchmarking and policy-relevant considerations such as reimbursement patterns and coding practice trends where available. Data not available in the input will be noted explicitly in relevant sections. This summary serves clinicians, coding professionals, and policy analysts seeking a national overview of the code’s clinical role and payer landscape.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare65782CPTophthalmologyocular-surface-reconstructionlimbal-conjunctival-graftsurgical-procedureambulatory-surgeryophthalmic-surgery

Billing Code Overview

CPT code 65782 describes a surgical procedure in which a clinician harvests a limbal conjunctival autograft from one of the patient’s eyes and transplants it to the other eye to reconstruct the ocular surface damaged by injury or disease. This procedure is a form of ocular surface reconstruction that restores the conjunctival and limbal tissues necessary for corneal and conjunctival health.

Service type: Surgical ocular surface reconstruction involving autologous limbal conjunctival grafting
Typical site of service: Ophthalmic operating room or ambulatory surgical center with ophthalmology surgical capabilities

Clinical & Coding Specifications

Clinical Context

A 45-year-old patient presents with symptomatic conjunctival scarring and limbal stem cell deficiency in the right eye after a chemical burn sustained 6 months earlier. The corneal surface shows persistent epithelial defects, neovascularization, and conjunctivalization causing pain, photophobia, and decreased vision. Conservative measures including lubricants, topical antibiotics, and bandage contact lens have failed. The ophthalmic surgeon plans a limbal conjunctival autograft from the patient’s contralateral left eye to reconstruct the ocular surface of the affected right eye using microsurgical technique under regional or general anesthesia. The workflow includes informed consent, preoperative assessment (visual acuity, slit-lamp exam, corneal staining, and photos), marking and harvesting of a limbal conjunctival autograft from the donor eye, preparation of the recipient bed on the affected eye, transplantation and suturing or tissue adhesive fixation of the graft, application of a therapeutic bandage contact lens, postoperative topical antibiotics and corticosteroids, and scheduled follow-up visits to monitor graft survival, epithelialization, and complications such as graft dehiscence or infection.

Coding Specifications

Modifier	Description	When to Use
`50`	Bilateral procedure	When procedures are performed on both eyes during the same operative session and payer requires bilateral reporting.

CPT 65760: Corneal Refractive Surgery to Improve Vision

CPT-65779-AMNIOTIC-MEMBRANE-OCULAR-SURFACE-PLACEMENT-SUTURED

CPT 65779: Amniotic Membrane Placement on Ocular Surface, Sutured

CPT-65771-CORNEAL-INCISIONAL-KERATOTOMY-MYOPIA

CPT 65771: Corneal Incisional Procedure to Reduce Myopia

CPT-65775-CORNEAL-WEDGE-INCISION-FOR-POSTSURGICAL-ASTIGMATISM

CPT 65775: Corneal Wedge Incision to Correct Postsurgical Astigmatism

CPT-65765-DONOR-ANTERIOR-CORNEAL-IMPLANTATION

CPT 65765: Donor Anterior Corneal Implantation, Surgical Corneal Transplant

CPT-65780-AMNIOGRAFT-OCULAR-SURFACE-RECONSTRUCTION-MULTILAYER

CPT 65780: Multilayer Amniograft Ocular Surface Reconstruction

CPT-65778-AMNIOTIC-MEMBRANE-PLACEMENT-OCULAR-SURFACE

CPT 65778: Amniotic Membrane Placement on Ocular Surface

CPT-65767-CORNEAL-REFRACTIVE-SURGERY-AMETROPIA

CPT 65767: Corneal Refractive Surgery for Ametropia

CPT-65772-CORNEAL-INCISION-CORRECTION-POSTOPERATIVE-ASTIGMATISM

CPT 65772: Corneal Incision to Correct Postoperative Astigmatism

CPT-65785-INTRACORNEAL-RING-SEGMENT-IMPLANTATION-KERATOCONUS-MYASTHENIA

CPT 65785: Intracorneal Ring Segment Implantation for Keratoconus/Myopia

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Taxonomy Code	Specialty	Notes
207K00000X	Ophthalmology	Primary specialty performing ocular surface reconstruction and limbal autografting.
207KA0400X	Cornea and External Disease	Subspecialists who commonly perform limbal conjunctival autografts for stem cell deficiency and surface reconstruction.
207KR0401X	Oculoplastic Surgery	May be involved when extensive conjunctival reconstruction or eyelid-related surface issues coexist.
2080S0002X	General Surgery (Ophthalmic surgeon with ocular surface focus)	Sometimes listed for surgical practitioners in ambulatory surgical centers.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H16.221`	Partial corneal ulcer, right eye	Corneal epithelial defects and ulceration may coexist with limbal stem cell deficiency requiring surface reconstruction.
`H16.223`	Partial corneal ulcer, left eye	Same as above for the left eye when bilateral disease is present.
`H16.10`	Keratitis, unspecified	Inflammatory conditions of the cornea that can damage limbal stem cells and conjunctiva, indicating need for transplantation.
`H18.59`	Other corneal degeneration, unspecified eye	Corneal surface disorders that may necessitate limbal/conjunctival reconstruction.
`T26.XXA`	Burn of eye and adnexa, initial encounter	Chemical or thermal burns are a common cause of limbal stem cell deficiency leading to autograft need.
`H11.39`	Other conjunctival degenerations	Conjunctival scarring or symblepharon formation that may require grafting to restore surface anatomy.
`H16.241`	Peripheral corneal ulcer, right eye	Peripheral ulcers with adjacent conjunctival involvement may prompt grafting procedures.
`H44.9`	Disorder of globe, unspecified	Broad code sometimes used when specific ocular surface diagnoses are not yet established but surgery is required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`65782`	Conjunctival autograft, with or without mucous membrane graft; from one eye to the other to reconstruct the ocular surface	Primary procedure: limbal conjunctival autograft as described.
`65785`	Conjunctival transplantation, from other than same individual (allograft)	Alternative graft source when autograft is not possible; relates as alternative technique.
`65435`	Repair of conjunctival laceration with sutures	May be performed when traumatic conjunctival defects are present and require primary repair in conjunction with grafting.
`65778`	Amniotic membrane graft, placement/repair	Often performed in ocular surface reconstruction either alone or in combination with conjunctival autograft to promote healing.
`69990`	Microsurgery, requiring use of an operating microscope	Ancillary CPT for use of operative microscope during delicate ocular surface surgery; billed when documented and allowed.
`99173`	Screening test of visual acuity, quantitative, unilateral or bilateral	Common preoperative and postoperative office measurement; used in clinical workflow for baseline and follow-up vision testing.

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