Summary & Overview
CPT 65815: Anterior Chamber Drainage for Intraocular Hemorrhage
Headline: CPT code 65815: Anterior Chamber Drainage to Manage Acute Intraocular Hemorrhage
CPT code 65815 represents an ophthalmic surgical procedure to drain blood and fluid from the eye's anterior chamber, sometimes combined with irrigation or air injection. The procedure is clinically significant because it is used in acute situations—such as central retinal artery occlusion or other anterior chamber compromise—that can rapidly threaten vision or cause permanent blindness if not addressed. Nationally, this code is pertinent to emergency and specialty ophthalmology care and factors into procedural utilization, facility resource needs, and payer reimbursement for sight-saving interventions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and what to expect from payer coverage patterns. The publication outlines benchmarks for utilization and payment trends, summarizes relevant policy developments affecting ophthalmic procedural billing, and provides guidance on common coding and billing considerations for this service line. Where input data is incomplete, the document notes the absence of specific fields. The focus is national in scope and intended for providers, billing professionals, and policy analysts interested in ophthalmology procedure coding and reimbursement.
Billing Code Overview
CPT code 65815 describes a procedure to drain fluid and blood from the anterior chamber of the eye. The provider may irrigate the eye or inject air into the anterior chamber as part of the intervention. This procedure is typically performed when an occlusion of the central retinal artery or related acute anterior chamber compromise threatens vision.
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Service type: Invasive ophthalmic anterior chamber drainage procedure
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Typical site of service: Ophthalmology procedure room, ambulatory surgery center, or hospital operating room
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Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents to the ophthalmology emergency clinic with sudden, painless loss of vision in one eye. Examination shows a shallow anterior chamber with hyphema and markedly elevated intraocular pressure after blunt ocular trauma. The ophthalmologist performs an anterior chamber paracentesis to drain blood and inflammatory fluid, irrigate the chamber, and, when needed, inject air to re-form the anterior chamber and restore intraocular anatomy. The clinical workflow includes urgent assessment (visual acuity, slit-lamp exam, intraocular pressure), topical and/or local anesthesia, sterile preparation, paracentesis using a fine blade or needle at the limbus to aspirate fluid, optional irrigation or air injection, post-procedure pressure check, topical antibiotics and steroid as indicated, and short-interval follow-up to monitor intraocular pressure and retinal perfusion. This procedure is also used emergently for central retinal artery occlusion when anterior chamber paracentesis is attempted to lower intraocular pressure and potentially restore retinal perfusion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work, time, and complexity substantially exceed usual for 65815. |