Summary & Overview
CPT 67218: Temporary Intraocular Brachytherapy for Retinal Malignancy
CPT code 67218 represents temporary intraocular brachytherapy: placement of a radiotherapeutic source within the eye to treat a cancerous retinal lesion with removal after four to five days. This targeted local radiation technique is a key treatment option for certain intraocular malignancies and carries implications for surgical scheduling, radiation safety, and specialist coordination across ophthalmology and radiation oncology. Nationally, the procedure matters for access to ocular oncology services and for payer coverage policies that influence provider facility selection and reimbursement pathways. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, and payer coverage landscape. The publication summarizes common billing modifiers associated with surgical and radiation services (input-provided list), highlights what information is available and what is not supplied, and outlines areas relevant to coding and billing workflows such as service classification and expected care setting. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
CPT code 67218 describes a procedure in which a provider temporarily implants a radiotherapeutic source within the eye to treat a cancerous lesion of the retina and then removes the source after four to five days. This is a surgical ophthalmologic radiation procedure performed to deliver localized brachytherapy to an intraocular malignancy.
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Service type: Radiation oncology procedure (temporary intraocular brachytherapy implant)
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Typical site of service: Ambulatory surgery center or hospital operating room with ocular oncology and radiation therapy capabilities.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult diagnosed with a primary intraocular malignancy such as a small to medium-sized choroidal or retinal melanoma requiring brachytherapy. The patient presents to an ocular oncology service after diagnosis via ophthalmic examination, ocular ultrasonography, and ocular imaging (fundus photography, fluorescein angiography, optical coherence tomography). The multidisciplinary workflow includes preoperative planning by an ocular oncologist or vitreoretinal surgeon, selection of an appropriately shaped and dosed radioactive plaque (commonly iodine-125), informed consent discussing temporary implant and planned removal after 4–5 days, and coordination with a radiation safety officer and medical physicist for dose calculation and shielding. The temporary episcleral plaque is surgically affixed to the sclera overlying the tumor under monitored anesthesia care or general anesthesia in the ambulatory surgery center or hospital operating room. The patient is discharged with radiation safety instructions and returns for plaque removal after the prescribed dwell time (typically 96–120 hours). Postoperative follow-up includes wound assessment, ophthalmic examination, imaging to assess tumor response, and management of radiation-related complications (radiation retinopathy, optic neuropathy, cataract). Typical site of service: hospital outpatient operating room or ambulatory surgery center. Service type: temporary brachytherapy implant with planned removal (radiation oncology/ocular oncology surgical procedure).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 |