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CPT 66940: Cataract Extraction with Capsular Retention
CPT code 66940 represents cataract surgery in which the surgeon removes the eye's natural lens while preserving the elastic capsular bag to allow implantation of an intraocular lens. This procedure is a common ophthalmic surgical service and has significant national importance due to its frequency, impact on vision restoration, and role in outpatient surgical care pathways.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service such as hospital outpatient departments and ambulatory surgical centers, and the operational billing considerations tied to this procedure. The publication addresses benchmarks for utilization and payment trends, common modifier usage relevant to surgical billing, and policy developments that affect coverage and coding practices for cataract extraction with capsular retention.
The article provides actionable reference material for revenue cycle leaders, coding professionals, and policy analysts seeking a national perspective on coding, billing, and administrative issues surrounding CPT code 66940. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 66940 describes a surgical procedure in which the provider removes the eye's natural lens while leaving the elastic capsule intact to permit placement of an intraocular lens. This is a type of cataract extraction with preservation of the capsular bag for intraocular lens implantation.
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Service type: Ophthalmic surgical procedure (cataract extraction with retained capsular support)
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Typical site of service: Hospital outpatient department or ambulatory surgical center specializing in ophthalmology