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CPT 67120: Removal of Implanted Extraocular Material From Posterior Segment
CPT code 67120 identifies the surgical removal of previously implanted extraocular material from the posterior segment of the eye. This intraocular posterior-segment procedure is clinically significant because it addresses complications or device revisions involving the vitreous cavity and adjacent structures, and it has implications for surgical complexity, site-of-service decisions, and payer coverage policies nationwide. Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical definition and typical settings, a summary of payer coverage patterns and common billing modifiers, and context on how the procedure fits into ophthalmic surgical practice. The publication highlights benchmark considerations for coding and claims submission, describes typical sites of service (hospital operating room and ambulatory surgical center), and summarizes policy considerations that affect prior authorization and documentation. Data not available in the input are noted where applicable. This analysis is intended to inform coding professionals, billing teams, and policy analysts about the clinical scope and payer relevance of CPT code 67120 on a national level.
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Billing Code Overview
CPT code 67120 describes the surgical removal of previously implanted extraocular material from the posterior segment of the eye — the back two-thirds of the globe. This procedure involves intraocular surgical techniques to extract devices, implants, or foreign material that were placed within the vitreous cavity or attached to posterior segment structures.
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Service Type: Posterior segment intraocular surgical removal (posterior ocular surgery)
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Typical Site of Service: Hospital operating room or ambulatory surgical center, given the intraocular posterior segment surgical setting