Summary & Overview
CPT 67121: Removal of Displaced Intraocular Lens from Posterior Segment
CPT code 67121 covers the surgical removal of a previously implanted intraocular lens that has subluxed or slipped into the posterior segment of the eye. This procedure is clinically important because displaced intraocular lenses can cause visual impairment, inflammation, retinal traction, and other complications that may require operative intervention. Nationally, the code is relevant to ophthalmic surgical practices, ambulatory surgical centers, and hospital-based eye services that manage complex cataract and lens-related complications.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing of the clinical context for the procedure, typical sites of service, and operational considerations that affect billing and coverage. The publication summarizes benchmarks where available, notes payer coverage considerations, and outlines the clinical circumstances that commonly lead to use of this code.
This summary offers clinicians, billing staff, and policy analysts a focused overview of what CPT code 67121 represents, why it matters for patient care and reimbursement workflows, and what types of documentation and care settings are typically involved. Data not available in the input is noted where relevant in the detailed sections.
Billing Code Overview
CPT code 67121 describes the surgical removal of a previously implanted intraocular lens that has subluxed or slipped into the posterior segment of the eye. This procedure addresses a displaced intraocular lens that has migrated behind the iris plane into the vitreous cavity or posterior chamber.
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Service type: Surgical ophthalmic procedure to remove a displaced intraocular lens
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Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult who previously underwent cataract extraction with intraocular lens (IOL) implantation and now presents with progressive vision loss, monocular diplopia, or new floaters. Examination reveals a subluxated or dislocated posterior chamber IOL that has migrated into the posterior segment (vitreous cavity). The clinical workflow begins with ophthalmic history and focused exam, including slit-lamp and dilated fundus examination. Diagnostic imaging such as B-scan ultrasound or optical coherence tomography may be used if the posterior segment view is limited. Preoperative assessment includes evaluation of comorbidities, anticoagulation status, and risks of retinal detachment or endophthalmitis. The procedure, reported with 67121, is typically performed in an ambulatory surgical center or hospital operating room by a vitreoretinal surgeon or anterior segment surgeon with posterior segment expertise under monitored anesthesia care or general anesthesia. Intraoperative steps include pars plana vitrectomy to clear the vitreous, localization and removal of the dislocated IOL, possible use of forceps or fragmatome for lens fragmentation, and attention to retinal stability. Postoperative care involves intraocular pressure control, antibiotic and steroid therapy, and close follow-up for retinal complications. Typical payors for authorization and claims include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |