Source: Nov. 2003 and Sept. 2009 CPT Assistant newsletters, AMA:
Cataract extraction in glaucoma patients can require complex techniques or maneuvers to accomplish cataract extraction and/or intraocular lens (IOL) insertion. For example, chronic administration of pupillary constriction medication (miotics) for glaucoma often reduces the pupillary response to mydriatics (drugs that cause pupillary dilation) administered before the extraction procedure. To overcome this situation and allow visualization of an access to the lens, the physician may need to use an iris expansion device, such as iris retractors (flexible retractors hooked onto the pupillary edge of the iris), to enlarge and maintain the pupillary opening during lens extraction and IOL insertion. In other situations, the physician may be able to accomplish dilation by performing multiple sphincterotomies in the iris (tiny, radial incisions in the sphincter muscle of the iris). Code 66982 is selected when extracapsular cataract extraction (ECCE) involves these or any one of the other techniques described in that code. NOTE: Dilation of the iris by manually stretching it with a hook inserted through the same incision does not justify the use of code 66982.
Source: Sept. 2009 CPT Assistant newsletter, AMA:
The use of a special pupil-stretching device such as a Beehler pupil stretcher or other such similar devices does justify use of this code.
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