ICD-9-CM Procedures (Ophthalmic Only).pdf

3
PREFACE
This sixth edition of the International Classification of Diseases, 9th Revision,
Clinical Modification (ICD- 9- CM) is being published by the United States
Government in recognition of its responsibility to promulgate this classification
throughout the United States for morbidity coding. The International
Classification of Diseases, 9th Revision, published by the World Health
Organization (WHO) is the foundation of the ICD- 9- CM and continues to be the
classification employed in cause- of- death coding in the United States. The
ICD- 9- CM is completely comparable with the ICD- 9. The WHO Collaborating
Center for Classification of Diseases in North America serves as liaison between
the international obligations for comparable classifications and the national
health data needs of the United States.
The ICD- 9- CM is recommended for use in all clinical settings but is required
for reporting diagnoses and diseases to all U.S. Public Health Service and the
Centers for Medicare & Medicaid Services (formerly the Health Care Financing
Administration) programs. Guidance in the use of this classification can be
found in the section "Guidance in the Use of ICD- 9- CM."
ICD- 9- CM extensions, interpretations, modifications, addenda, or errata other
than those approved by the U.S. Public Health Service and the Centers for
Medicare & Medicaid Services are not to be considered official and should not
be utilized. Continuous maintenance of the ICD- 9- CM is the responsibility of
the Federal Government. However, because the ICD- 9- CM represents the best
in contemporary thinking of clinicians, nosologists, epidemiologists, and
statisticians from both public and private sectors, no future modifications will
be considered without extensive advice from the appropriate representatives of
all major users.
All official authorized addenda through October 1, 2009, have been included in
this sixth edition.

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AC K NOW L E DG ME NT
David Berglund, MD, MPH
Classifications and Public Health Data Standards Staff
National Center for Health Statistics
Centers for Disease Control and Prevention
Amy L. Blum, MHSA., RHIA, CTR
Lizabeth J. Fisher, RHIA
Donna Pickett, MPH, RHIA
Patricia E. Brooks, RHIA
Centers For Medicare and Medicaid Services
Center for Medicare Management
Hospital and Ambulatory Policy Group
Division of Acute Care
Ann B. Fagan, RHIA
Amy L. Gruber, RHIA
Mady Hue, RHIA, CCS
Linda Washington
Marketing
Development InfoStructure
2101 Wilson Boulevard, Suite 300
Arlington, VA 22201
Contact: David W. Martin

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INTRODUCTION
The International Classification of Diseases, 9th Revision, Clinical Modification
(ICD- 9- CM) is based on the official version of the World Health Organization's
9th Revision, International Classification of Diseases (ICD- 9). ICD- 9 is designed
for the classification of morbidity and mortality information for statistical
purposes, and for the indexing of hospital records by disease and operations, for
data storage and retrieval. The historical background of the International
Classification of Diseases may be found in the Introduction to ICD- 9 (Manual of
the International Classification of Diseases, Injuries, and Causes of Death, World
Health Organization, Geneva, Switzerland, 1977).
ICD- 9- CM is a clinical modification of the World Health Organization's
International Classification of Diseases, 9th Revision (ICD- 9). The term "clinical" is
used to emphasize the modification's intent: to serve as a useful tool in the area
of classification of morbidity data for indexing of medical records, medical care
review, and ambulatory and other medical care programs, as well as for basic
health statistics. To describe the clinical picture of the patient, the codes must be
more precise than those needed only for statistical groupings and trend analysis..
THE IC D - 9 - C M C OOR DINATION AND MAINTE NANC E C OMMITTE E
Annual modifications are made to the ICD- 9- CM through the ICD- 9- CM
Coordination and Maintenance Committee (C&M). The Committee is made up of
representatives from two Federal Government agencies, the National Center for
Health Statistics and the Centers for Medicare & Medicaid Services. The
Committee holds meetings twice a year which are open to the public.
Modifcation proposals submitted to the Committee for consideration are
presented at the meetings for public discussion. Those modification proposals
which are approved are incorporated into the official government version of the
ICD- 9- CM and become effective for use the October 1 of the year following their
presentation. This CD- ROM contains the modifications approved from the March
2008 - March 2009 C&M cycle.
This CD- ROM is the only official federal government version of the ICD- 9- CM. It
may be purchased through the Government Printing Office.
C ONVE NTION U E D IN THE TA UL AR L I T
The ICD- 9- CM Tabular List for both the Disease and Procedure Classification
makes use of certain abbreviations, punctuation, and other conventions which
need to be clearly understood.
Abbreviations
NEC Not elsewhere classifiable. The category number for the term including NEC is
to be used only when the coder lacks the information necessary to code the
term to a more specific category.
NO Not otherwise specified. This abbreviation is the equivalent of "unspecified."
P unc tuation
[ ] Brackets are used to enclose synonyms, alternative wordings, or
explanatory phrases.

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() Parentheses are used to enclose supplementary words which may be present
or absent in the statement of a disease or procedure without affecting the
code number to which it is assigned.
Colons are used in the Tabular List after an incomplete term which needs one
or more of the modifiers which follow in order to make it assignable to a given
category.
OTHE R C ONVE NTION
Format: ICD- 9- CM uses an indented format for ease in reference.
Instruc tional Notations
Inc ludes
This note appears immediately under a three- digit code title to further define,
or give example of, the contents of the category.
E xc ludes
Terms following the word "excludes" are to be coded elsewhere. The term
excludes means "DO NOT CODE HERE".
Use additional c ode
This instruction is placed in the Tabular List in those categories where the
user will need to add further information (by using an additional code) to give
a more complete picture of the diagnosis or procedure.
G UIDANC E IN THE U E OF IC D - 9 - C M
To code accurately, it is necessary to have a working knowledge of medical
terminology and to understand the characteristics, terminology, and conventions
of the ICD- 9- CM. Transforming verbal descriptions of diseases, injuries,
conditions, and procedures into numerical designations (coding) is a complex
activity and should not be undertaken without proper training.
Originally coding was accomplished to provide access to medical records by
diagnoses and operations through retrieval for medical research, education, and
administration. Medical codes today are utilized to facilitate payment of health
services, to evaluate utilization patterns, and to study the appropriateness of
health care costs. Coding provides the bases for epidemiological studies and
research into the quality of health care.
Coding must be performed correctly and consistently to produce meaningful
statistics to aid in the planning for the health needs of the Nation.
QUE TION
Questions regarding the use and interpretation of the International Classification of Diseases,
9th Revision, Clinical Modification can be directed to any of the organizations listed below.
C entral Offic e on IC D - 9 - C M
American Hospital Association
1 North Franklin Chicago, Illinois 60606
National C enter for Health tatistic s
Department of Health and Human Services
3311 Toledo Road
Hyattsville, Maryland 20782
C enters for Medic are & Medic aid ervic es
Division of Prospective Payment System
Office of Hospital Policy
7500 Security Blvd., C5- 06- 27
Baltimore, Maryland 21244- 1850

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TA LE OF CONTENT
C L A IF IC ATION OF P R OC E DUR E
C hapter C ode P age
0 00 Procedures and interventions, not elsewhere
classified
11
1 01- 05 Operations on the nervous system 22
2 06- 07 Operations on the endocrine system 32
3 08- 16 Operations on the eye 37
3A 17 Other miscellaneous diagnostic and therapeutic
procedures
51
4 18- 20 Operations on the ear 54
5 21- 29 Operations on the nose, mouth, and pharynx 60
6 30- 34 Operations on the respiratory system 72
7 35- 39 Operations on the cardiovascular system 82
8 40- 41 Operations on the hemic and lymphatic system 113
9 42- 54 Operations on the digestive system 116
10 55- 59 Operations on the urinary system 153
11 60- 64 Operations on the male genital organs 166
12 65- 71 Operations on the female genital organs 173
13 72- 75 Obstetrical procedures 188
14 76- 84 Operations on the musculoskeletal system 193
15 85- 86 Operations on the integumentary system 223
16 87- 99 Miscellaneous diagnostic and therapeutic
procedures
233
INDE X TO P R OC E DUR E 273

9
CLA IF ICATION OF P ROCE DURE

PROCEDURES AND INTERVENTIONS, NOT ELSEWHERE CLASSIFIED (00)
 New code ® Revised code  4th
digit required 11
0 P R OC E DUR E AND INTE R VE NTION NOT E L E W HE R E C L A IF IE D (00)
00 Procedures and interventions Not Elsewhere Classified
00 0 Therapeutic ultrasound
Excludes: diagnostic ultrasound (non-invasive) (88.71-88.79)
intracardiac echocardiography [ICE] (heart chamber(s)) (37.28)
intravascular imaging (adjunctive) (00.21-00.29)
00 01 Therapeutic ultrasound of vessels of head and nec k
Anti- restenotic ultrasound
Intravascular non- ablative ultrasound
Excludes: diagnostic ultrasound of:
eye (95.13)
head and neck (88.71)
that of inner ear (20.79)
ultrasonic:
angioplasty of non-coronary vessel (39.50)
embolectomy (38.01, 38.02)
endarterectomy (38.11, 38.12)
thrombectomy (38.01, 38.02)
00 02 Therapeutic ultrasound of heart ®
Excludes: diagnostic ultrasound of heart (88.72)
ultrasonic ablation of heart lesion (37.34)
ultrasonic angioplasty of coronary vessels (00.66, 36.09)
00 03 Therapeutic ultrasound of peripheral vasc ular vessels
Excludes: diagnostic ultrasound of peripheral vascular system (88.77)
ultrasonic angioplasty of:
non-coronary vessel (39.50)
00 09 Other therapeutic ultrasound
Excludes: ultrasonic:
fragmentation of urinary stones (59.95)
percutaneous nephrostomy with fragmentation (55.04)
physical therapy (93.35)
transurethral guided laser induced prostatectomy
(TULIP) (60.21)
00 1 P haramac eutic als
00 10 Implantation of c hemotherapeutic agent
Brain wafer chemotherapy
Interstitial/ intracavitary
Excludes: injection or infusion of cancer chemotherapeutic
substance (99.25)
00 11 Infusion of drotrec ogin alfa (ac tivated)
Infusion of recombinant protein

digit required 13
00 23 Intravasc ular imaging of peripheral vessels
Imaging of:
vessels of arm(s)
vessels of leg(s)
Intravascular ultrasound (IVUS), peripheral vessels
Excludes: diagnostic ultrasound (non-invasive) of peripheral
vascular system (88.77)
00 24 Intravasc ular imaging of c oronary vessels
Intravascular ultrasound (IVUS), coronary vessels
Excludes: diagnostic ultrasound (non-invasive) of heart (88.72)
intracardiac echocardiography [ICE] (ultrasound of
heart chamber(s)) (37.28)
00 25 Intravasc ular imaging of renal vessels
Intravascular ultrasound (IVUS), renal vessels
Renal artery
Excludes: diagnostic ultrasound (non-invasive) of urinary system
(88.75)
00 28 Intravasc ular imaging other spec ified vessel(s)
00 29 Intravasc ular imaging unspec ified vessel(s)
00 3 Computer assisted surgery [CA ] ®
CT- free navigation
Image guided navigation (IGN)
Image guided surgery (IGS)
Imageless navigation
That without the use of robotic(s) technology
Code also diagnostic or therapeutic procedure
Excludes: stereotactic frame application only (93.59)
robotic assisted procedures (17.41-17.49)
00 31 C omputer assisted surgery with C T / C TA
00 32 C omputer assisted surgery with MR / MR A
00 33 C omputer assisted surgery with fluorosc opy
00 34 Imageless c omputer assisted surgery
00 35 C omputer assisted surgery with multiple datasets
00 39 Other c omputer assisted surgery
Computer assisted surgery NOS

digit required 15
other removal of coronary obstruction (36.09)
percutaneous transluminal coronary angioplasty [PTCA] (00.66)
procedure on vessel bifurcation (00.44)
Excludes: other oxygen enrichment (93.96)
other perfusion (39.97)
00 5 Other c ardiovasc ular proc edures
00 50 Implantation of c ardiac resync hronization pac emaker without
mention of defibrillation total system [C R T - P ]
Biventricular pacemaker
Biventricular pacing without internal cardiac defibrillator
BiV pacemaker
Implantation of cardiac resynchronization (biventricular) pulse
generator pacing device, formation of pocket, transvenous
leads including placement of lead into left ventricular coronary
venous system, and intraoperative procedures for evaluation
of lead signals.
That with CRT- P generator and one or more leads
Note: Device testing during procedure --omit code
Excludes: implantation of cardiac resynchronization defibrillator,
total system [CRT-D] (00.51)
insertion or replacement of any type pacemaker device
(37.80-37.87)
replacement of cardiac resynchronization defibrillator
pulse generator only [CRT-D] (00.54)
replacement of cardiac resynchronization pacemaker
pulse generator only [CRT-P] (00.53)
00 51 Implantation of c ardiac resync hronization defibrillator total
system [C R T - D]
BiV defibrillator
Biventricular defibrillator
Biventricular pacing with internal cardiac defibrillator
BiV ICD
BiV pacemaker with defibrillator
BiV pacing with defibrillator
Implantation of a cardiac resynchronization (biventricular) pulse
generator with defibrillator [AICD], formation of pocket,
transvenous leads, including placement of lead into left
ventricular coronary venous system, intraoperative procedures
for evaluation of lead signals, and obtaining defibrillator
threshold measurements.
That with CRT- D generator and one or more leads
Excludes: implantation of cardiac resynchronization pacemaker,
total system [CRT-P] (00.50)
implantation or replacement of automatic
cardioverter/defibrillator, total system [AICD] (37.94)
replacement of cardiac resynchronization defibrillator
pulse generator, only [CRT-D] (00.54)

ICD-9-CM TABULAR LIST OF PROCEDURES (FY10)
16 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG
00 52 Implantation or replac ement of transvenous lead [elec trode]
into left ventric ular c oronary venous system
Excludes: implantation of cardiac resynchronization
defibrillator, total system [CRT-D] (00.51)
implantation of cardiac resynchronization
pacemaker, total system [CRT-P] (00.50)
initial insertion of transvenous lead [electrode]
(37.70-37.72)
replacement of transvenous atrial and/or ventricular
lead(s) [electrodes] (37.76)
00 53 Implantation or replac ement of c ardiac resync hronization
pac emaker pulse generator only [C R T - P ]
Implantation of CRT- P device with removal of any existing CRT- P
or other pacemaker device
Excludes: implantation of cardiac resynchronization
pacemaker, total system [CRT-P] (00.50)
implantation or replacement of cardiac resynchronization
defibrillator pulse generator only [CRT-D] (00.54)
insertion or replacement of any type pacemaker device
(37.80-37.87)
00 54 Implantation or replac ement of c ardiac resync hronization
defibrillator pulse generator devic e only [C R T - D]
Implantation of CRT- D device with removal of any existing CRT- D,
CRT- P, pacemaker, or defibrillator device
Excludes: implantation of automatic cardioverter/defibrillator pulse
generator only (37.96)
implantation of cardiac resynchronization defibrillator,
total system [CRT-D] (00.51)
implantation or replacement of cardiac resynchronization
pacemaker pulse generator only [CRT-P] (00.53)
00 55 Insertion of drug - eluting peripheral vessel stent(s)
Endograft(s)
Endovascular graft(s)
Stent grafts
Code also any:
angioplasty or atherectomy of other non- coronary vessels(s) (39.50)
number of vascular stents inserted (00.45 00.48)
number of vessels treated (00.40 00.43)
Excludes: drug-coated peripheral stents, e.g., heparin coated (39.90)
insertion of cerebrovascular stent(s) (00.63-00.65)
insertion of drug-eluting coronary artery stent (36.07)
insertion of non-drug-eluting stent(s):
coronary artery (36.06)
peripheral vessel (39.90)
that for aneurysm repair (39.71 - 39.79)

digit required 17
00 56 Insertion or replac ement of implantable pressure sensor (lead)
for intrac ardiac or great vessel hemodynamic monitoring ®
Code also any associated implantation or replacement of monitor
(00.57)
Excludes: circulatory monitoring (blood gas, arterial or venous
pressure, cardiac output and coronary blood flow)
(89.60 - 89.69)
00 57 Implantation or replac ement of subc utaneous devic e for
intrac ardiac or great vessel hemodynamic monitoring ®
Implantation of monitoring device with formation of subcutaneous
pocket and connection to intracardiac pressure sensor (lead)
Code also any associated insertion or replacement of implanted
pressure sensor (lead) (00.56)
00 58 Insertion of intra - aneurysm sac pressure monitoring devic e
(intraoperative) 
Insertion of pressure sensor during endovascular repair of
abdominal or thoracic aortic aneurysm(s)
00 59 Intravasc ular pressure measurement of c oronary arteries 
Includes: fractional flow reserve (FFR)
Code also any synchronous diagnostic or therapeutic procedures
Excludes: intravascular pressure measurement of intrathoracic
arteries (00.67)
00 6 P roc edures on blood vessels
00 61 P erc utaneous angioplasty or atherec tomy of prec erebral
(extrac ranial) vessel(s)
Basilar
Carotid
Vertebral
Code also any:
injection or infusion of thrombolytic agent (99.10)
percutaneous insertion of carotid artery stent(s) (00.63)
percutaneous insertion of other precerebral artery stent(s) (00.64)
Excludes: angioplasty or atherectomy of other non-coronary vessel(s)
(39.50)
removal of cerebrovascular obstruction of vessel(s) by open
approach (38.01-38.02, 38.11-38.12, 38.31-38.32,
38.41-38.42)
00 62 P erc utaneous angioplasty or atherec tomy of intrac ranial vessel(s)
Code also any:
injection or infusion of thrombolytic agent (99.10)
percutaneous insertion of intracranial stent(s) (00.65)

(39.50)
removal of cerebrovascular obstruction of vessel(s) by open
approach (38.01-38.02, 38.11-38.12, 38.31-38.32,
38.41-38.42)
00 63 P erc utaneous insertion of c arotid artery stent(s)
Includes the use of any embolic protection device, distal protection
device, filter device, or stent delivery system
Non- drug- eluting stent
Code also any:
percutaneous angioplasty or atherectomy of precerebral vessel(s)
(00.61)
(39.50)
insertion of drug-eluting peripheral vessel stent(s) (00.55)
00 64 P erc utaneous insertion of other prec erebral (extrac ranial) artery
stent(s)
Basilar stent
Vertebral stent
Code also any:
percutaneous angioplasty or atherectomy of precerebral vessel(s)
(00.61)
(39.50)
00 65 P erc utaneous insertion of intrac ranial vasc ular stent(s)
Code also any:
percutaneous angioplasty or atherectomy of intracranial vessel(s)
(00.62)
(39.50)

digit required 21
00 82 R evision of knee replac ement femoral c omponent
That with replacement of tibial insert (liner)
Excludes: revision of knee replacement, total (all components) (00.80)
00 83 R evision of knee replac ement patellar c omponent
Excludes: revision of knee replacement, total (all components) (00.80)
00 84 R evision of total knee replac ement tibial insert (liner)
Replacement of tibial insert (liner)
Excludes: that with replacement of tibial component (tibial baseplate
and liner) (00.81)
00 85 R esurfac ing hip total ac etabulum and femoral head
Hip resurfacing arthroplasty, total
00 86 R esurfac ing hip partial femoral head
Hip resurfacing arthroplasty, NOS
Hip resurfacing arthroplasty, partial, femoral head
Excludes: that with resurfacing of acetabulum (00.85)
00 87 R esurfac ing hip partial ac etabulum
Hip resurfacing arthroplasty, partial, acetabulum
Excludes: that with resurfacing of femoral head (00.85)
00 9 Other proc edures and interventions
00 91 Transplant from live related donor
Code also organ transplant procedure
00 92 Transplant from live non - related donor
00 93 Transplant from c adaver
00 94 Intra - operative neurophysiologic monitoring 
Includes: Cranial nerve, peripheral nerve and spinal cord
testing performed intra- operatively
Intra- operative neurophysiologic testing
IOM
Nerve monitoring
Neuromonitoring
Excludes: brain temperature monitoring (01.17)
intracranial oxygen monitoring (01.16)
intracranial pressure monitoring (01.10)
plethysmogram (89.58)

OPERATIONS ON THE EYE (08-16))
37 1 .1 OR procedure 0 .2 Non OR procedure but affects ThaiDRG
3 OP E R ATION ON THE E YE (08 - 16)
08 Operations on eyelids
Includes: operations on the eyebrow
08 0 Inc ision of eyelid
08 01 Inc ision of lid margin
08 02 evering of blepharorrhaphy
08 09 Other inc ision of eyelid
08 1 Diagnostic proc edures on eyelid
08 11 iopsy of eyelid
08 19 Other diagnostic proc edures on eyelid
08 2 E xc ision or destruc tion of lesion or tissue of eyelid
Code also any synchronous reconstruction (08.61- 08.74)
Excludes: biopsy of eyelid (08.11)
08 20 R emoval of lesion of eyelid not otherwise spec ified
Removal of meibomian gland NOS
08 21 E xc ision of c halazion
08 22 E xc ision of other minor lesion of eyelid
Excision of:
verucca
wart
08 23 E xc ision of major lesion of eyelid partial - thic kness
Excision involving one- fourth or more of lid margin, partial- thickness
08 24 E xc ision of major lesion of eyelid full - thic kness
Excision involving one- fourth or more of lid margin, full- thickness
Wedge resection of eyelid
08 25 Destruc tion of lesion of eyelid
08 3 R epair of blepharoptosis and lid retrac tion
08 31 R epair of blepharoptosis by frontalis musc le tec hnique with suture
08 32 R epair of blepharoptosis by frontalis musc le tec hnique with fasc ial
sling
08 33 R epair of blepharoptosis by resec tion or advanc ement of levator
musc le or aponeurosis
08 34 R epair of blepharoptosis by other levator musc le tec hniques
08 35 R epair of blepharoptosis by tarsal tec hnique
08 36 R epair of blepharoptosis by other tec hniques
Correction of eyelid ptosis NOS
Orbicularis oculi muscle sling for correction of blepharoptosis
08 37 R educ tion of overc orrec tion of ptosis
08 38 C orrec tion of lid retrac tion

08 4 R epair of entropion or ec tropion
08 41 R epair of entropion or ec tropion by thermoc auterization
08 42 R epair of entropion or ec tropion by suture tec hnique
08 43 R epair of entropion or ec tropion with wedge resec tion
08 44 R epair of entropion or ec tropion with lid rec onstruc tion
08 49 Other repair of entropion or ec tropion
08 5 Other adjustment of lid position
08 51 C anthotomy
Enlargement of palpebral fissure
08 52 lepharorrhaphy
Canthorrhaphy
Tarsorrhaphy
08 59 Other
Canthoplasty NOS
Repair of epicanthal fold
08 6 R ec onstruc tion of eyelid with flaps or grafts
Excludes: that associated with repair of entropion and ectropion (08.44)
08 61 R ec onstruc tion of eyelid with skin flap or graft
08 62 R ec onstruc tion of eyelid with muc ous membrane flap or graft
08 63 R ec onstruc tion of eyelid with hair follic le graft
08 64 R ec onstruc tion of eyelid with tarsoc onjunc tival flap
Transfer of tarsoconjunctival flap from opposing lid
08 69 Other rec onstruc tion of eyelid with flaps or grafts
08 7 Other rec onstruc tion of eyelid
Excludes: that associated with repair of entropion and ectropion (08.44)
08 70 R ec onstruc tion of eyelid not otherwise spec ified
08 71 R ec onstruc tion of eyelid involving lid margin partial - thic kness
08 72 Other rec onstruc tion of eyelid partial - thic kness
08 73 R ec onstruc tion of eyelid involving lid margin full - thic kness
08 74 Other rec onstruc tion of eyelid full - thic kness
08 8 Other repair of eyelid
08 81 L inear repair of lac eration of eyelid or eyebrow
08 82 R epair of lac eration involving lid margin partial - thic kness
08 83 Other repair of lac eration of eyelid partial - thic kness
08 84 R epair of lac eration involving lid margin full - thic kness
08 85 Other repair of lac eration of eyelid full - thic kness
08 86 L ower eyelid rhytidec tomy
08 87 Upper eyelid rhytidec tomy
08 89 Other eyelid repair

digit required 39
08 9 Other operations on eyelids
08 91 E lec trosurgic al epilation of eyelid
08 92 C ryosurgic al epilation of eyelid
08 93 Other epilation of eyelid
08 99 Other
09 Operations on lacrimal system
09 0 Inc ision of lac rimal gland
Incision of lacrimal cyst (with drainage)
09 1 Diagnostic proc edures on lac rimal system
09 11 iopsy of lac rimal gland
09 12 iopsy of lac rimal sac
09 19 Other diagnostic proc edures on lac rimal system
Excludes: contrast dacryocystogram (87.05)
soft tissue x-ray of nasolacrimal duct (87.09)
09 2 E xc ision of lesion or tissue of lac rimal gland
09 20 E xc ision of lac rimal gland not otherwise spec ified
09 21 E xc ision of lesion of lac rimal gland
Excludes: biopsy of lacrimal gland (09.11)
09 22 Other partial dac ryoadenec tomy
Excludes: biopsy of lacrimal gland (09.11)
09 23 Total dac ryoadenec tomy
09 3 Other operations on lac rimal gland
09 4 Manipulation of lac rimal passage
Includes: removal of calculus
that with dilation
Excludes: contrast dacryocystogram (87.05)
09 41 P robing of lac rimal punc tum
09 42 P robing of lac rimal c analic uli
09 43 P robing of nasolac rimal duc t
Excludes: that with insertion of tube or stent (09.44)
09 44 Intubation of nasolac rimal duc t
Insertion of stent into nasolacrimal duct
09 49 Other manipulation of lac rimal passage
09 5 Inc ision of lac rimal sac and passages
09 51 Inc ision of lac rimal punc tum
09 52 Inc ision of lac rimal c analic uli
09 53 Inc ision of lac rimal sac
09 59 Other inc ision of lac rimal passages
Incision (and drainage) of nasolacrimal duct NOS

09 6 E xc ision of lac rimal sac and passage
Excludes: biopsy of lacrimal sac (09.12)
09 7 R epair of c analic ulus and punc tum
Excludes: repair of eyelid (08.81-08.89)
09 71 C orrec tion of everted punc tum
09 72 Other repair of punc tum
09 73 R epair of c analic ulus
09 8 F istulization of lac rimal trac t to nasal c avity
09 81 Dac ryoc ystorhinostomy [DC R ]
09 82 C onjunc tivoc ystorhinostomy
Conjunctivodacryocystorhinostomy [CDCR]
Excludes: that with insertion of tube or stent (09.83)
09 83 C onjunc tivorhinostomy with insertion of tube or stent
09 9 Other operations on lac rimal system
09 91 Obliteration of lac rimal punc tum
09 99 Other
10 Operations on conjunctiva
10 0 R emoval of embedded foreign body from c onjunc tiva by inc ision
Excludes: removal of:
embedded foreign body without incision (98.22)
superficial foreign body (98.21)
10 1 Other inc ision of c onjunc tiva
10 2 Diagnostic proc edures on c onjunc tiva
10 21 iopsy of c onjunc tiva
10 29 Other diagnostic proc edures on c onjunc tiva
10 3 E xc ision or destruc tion of lesion or tissue of c onjunc tiva
10 31 E xc ision of lesion or tissue of c onjunc tiva
Excision of ring of conjunctiva around cornea
Excludes: biopsy of conjunctiva (10.21)
10 32 Destruc tion of lesion of c onjunc tiva
Excludes: excision of lesion (10.31)
thermocauterization for entropion (08.41)
10 33 Other destruc tive proc edures on c onjunc tiva
Removal of trachoma follicles
10 4 Conjunc tivoplasty
10 41 R epair of symblepharon with free graft
10 42 R ec onstruc tion of c onjunc tival c ul - de - sac with free graft
Excludes: revision of enucleation socket with graft (16.63)

digit required 41
10 43 Other rec onstruc tion of c onjunc tival c ul - de - sac
Excludes: revision of enucleation socket (16.64)
10 44 Other free graft to c onjunc tiva
10 49 Other c onjunc tivoplasty
Excludes: repair of cornea with conjunctival flap (11.53)
10 5 L ysis of adhesions of c onjunc tiva and eyelid
Division of symblepharon (with insertion of conformer)
10 6 R epair of lac eration of c onjunc tiva
Excludes: that with repair of sclera (12.81)
10 9 Other operations on c onjunc tiva
10 91 ubc onjunc tival injec tion
10 99 Other
11 Operations on cornea
11 0 Magnetic removal of embedded foreign body from c ornea
Excludes: that with incision (11.1)
11 1 Inc ision of c ornea
Incision of cornea for removal of foreign body
11 2 Diagnostic proc edures on c ornea
11 21 c raping of c ornea for smear or c ulture
11 22 iopsy of c ornea
11 29 Other diagnostic proc edures on c ornea
11 3 E xc ision of pterygium
11 31 Transposition of pterygium
11 32 E xc ision of pterygium with c orneal graft
11 39 Other exc ision of pterygium
11 4 E xc ision or destruc tion of tissue or other lesion of c ornea
11 41 Mec hanic al removal of c orneal epithelium
That by chemocauterization
Excludes: that for smear or culture (11.21)
11 42 Thermoc auterization of c orneal lesion
11 43 C ryotherapy of c orneal lesion
11 49 Other removal or destruc tion of c orneal lesion
Excision of cornea NOS
Excludes: biopsy of cornea (11.22)
11 5 R epair of c ornea
11 51 uture of c orneal lac eration
11 52 R epair of postoperative wound dehisc enc e of c ornea
11 53 R epair of c orneal lac eration or wound with c onjunc tival flap
11 59 Other repair of c ornea

11 6 Corneal transplant
Excludes: excision of pterygium with corneal graft (11.32)
11 60 C orneal transplant not otherwise spec ified
Keratoplasty NOS
Note: To report donor source --see codes 00.91- 00.93
11 61 L amellar keratoplasty with autograft
11 62 Other lamellar keratoplasty
11 63 P enetrating keratoplasty with autograft
Perforating keratoplasty with autograft
11 64 Other penetrating keratoplasty
Perforating keratoplasty (with homograft)
11 69 Other c orneal transplant
11 7 Other rec onstruc tive and refrac tive surgery on c ornea
11 71 K eratomileusis
11 72 K eratophakia
11 73 K eratoprosthesis
11 74 Thermokeratoplasty
11 75 R adial keratotomy
11 76 E pikeratophakia
11 79 Other
11 9 Other operations on c ornea
11 91 Tattooing of c ornea
11 92 R emoval of artific ial implant from c ornea
11 99 Other
12 Operations on iris ciliary body sclera and anterior chamber
Excludes: operations on cornea (11.0-11.99)
12 0 R emoval of intraoc ular foreign body from anterior segment of eye
not otherwise spec ified
with use of magnet
without use of magnet
12 1 Iridotomy and simple iridec tomy
Excludes: iridectomy associated with:
cataract extraction (13.11- 13.69)
removal of lesion (12.41- 12.42)
scleral fistulization (12.61- 12.69)
12 11 Iridotomy with transfixion

digit required 43
12 12 Other iridotomy
Corectomy
Discission of iris
Iridotomy NOS
12 13 E xc ision of prolapsed iris
12 14 Other iridec tomy
Iridectomy (basal) (peripheral) (total)
12 2 Diagnostic proc edures on iris c iliary body sc lera and anterior
c hamber
12 21 Diagnostic aspiration of anterior c hamber of eye
12 22 iopsy of iris
12 29 Other diagnostic proc edures on iris c iliary body sc lera and
anterior c hamber
12 3 Iridoplasty and c oreoplasty
12 31 L ysis of goniosynec hiae
Lysis of goniosynechiae by injection of air or liquid
12 32 L ysis of other anterior synec hiae
Lysis of anterior synechiae:
NOS
by injection of air or liquid
12 33 L ysis of posterior synec hiae
Lysis of iris adhesions NOS
12 34 L ysis of c orneovitreal adhesions
12 35 C oreoplasty
Needling of pupillary membrane
12 39 Other iridoplasty
12 4 E xc ision or destruc tion of lesion of iris and c iliary body
12 40 R emoval of lesion of anterior segment of eye not otherwise
spec ified
12 41 Destruc tion of lesion of iris nonexc isional
Destruction of lesion of iris by:
cauterization
cryotherapy
photocoagulation
12 42 E xc ision of lesion of iris
Excludes: biopsy of iris (12.22)
12 43 Destruc tion of lesion of c iliary body nonexc isional
12 44 E xc ision of lesion of c iliary body
12 5 F ac ilitation of intraoc ular c irc ulation
12 51 G oniopunc ture without goniotomy
12 52 G oniotomy without goniopunc ture
12 53 G oniotomy with goniopunc ture
12 54 Trabec ulotomy ab externo

12 55 C yc lodialysis
12 59 Other fac ilitation of intraoc ular c irc ulation
12 6 c leral fistulization
Excludes: exploratory sclerotomy (12.89)
12 61 Trephination of sc lera with iridec tomy
12 62 Thermoc auterization of sc lera with iridec tomy
12 63 Iridenc leisis and iridotasis
12 64 Trabec ulec tomy ab externo
12 65 Other sc leral fistulization with iridec tomy
12 66 P ostoperative revision of sc leral fistulization proc edure
Revision of filtering bleb
Excludes: repair of fistula (12.82)
12 69 Other fistulizing proc edure
12 7 Other proc edures for relief of elevated intraoc ular pressure
12 71 C yc lodiathermy
12 72 C yc loc ryotherapy
12 73 C yc lophotoc oagulation
12 74 Diminution of c iliary body not otherwise spec ified
12 79 Other glauc oma proc edures
12 8 Operations on sc lera
Excludes: those associated with:
retinal reattachment (14.41-14.59)
scleral fistulization (12.61-12.69)
12 81 uture of lac eration of sc lera
Suture of sclera with synchronous repair of conjunctiva
12 82 R epair of sc leral fistula
Excludes: postoperative revision of scleral fistulization procedure (12.66)
12 83 R evision of operative wound of anterior segment not elsewhere
c lassified
Excludes: postoperative revision of scleral fistulization procedure (12.66)
12 84 E xc ision or destruc tion of lesion of sc lera
12 85 R epair of sc leral staphyloma with graft
12 86 Other repair of sc leral staphyloma
12 87 c leral reinforc ement with graft
12 88 Other sc leral reinforc ement
12 89 Other operations on sc lera
Exploratory sclerotomy
12 9 Other operations on iris c iliary body and anterior c hamber
12 91 Therapeutic evac uation of anterior c hamber
Paracentesis of anterior chamber
Excludes: diagnostic aspiration (12.21)

digit required 45
12 92 Injec tion into anterior c hamber
Injection of:
air into anterior chamber
liquid into anterior chamber
medication into anterior chamber
12 93 R emoval or destruc tion of epithelial downgrowth from anterior
c hamber
Excludes: that with iridectomy (12.41-12.42)
12 97 Other operations on iris
12 98 Other operations on c iliary body
12 99 Other operations on anterior c hamber
13 Operations on lens
13 0 R emoval of foreign body from lens
Excludes: removal of pseudophakos (13.8)
13 00 R emoval of foreign body from lens not otherwise spec ified
13 01 R emoval of foreign body from lens with use of magnet
13 02 R emoval of foreign body from lens without use of magnet
13 1 Intrac apsular extrac tion of lens
Code also any synchronous insertion of pseudophakos (13.71)
13 11 Intrac apsular extrac tion of lens by temporal inferior route
13 19 Other intrac apsular extrac tion of lens
Cataract extraction NOS
Cryoextraction of lens
Erysiphake extraction of cataract
Extraction of lens NOS
13 2 E xtrac apsular extrac tion of lens by linear extrac tion tec hnique ®
13 3 E xtrac apsular extrac tion of lens by simple aspiration (and
irrigation) tec hnique ®
Irrigation of traumatic cataract
13 4 E xtrac apsular extrac tion of lens by fragmentation and aspiration
tec hnique ®
13 41 P hac oemulsific ation and aspiration of c atarac t
13 42 Mec hanic al phac ofragmentation and aspiration of c atarac t by
posterior route
Code also any synchronous vitrectomy (14.74)
13 43 Mec hanic al phac ofragmentation and other aspiration of c atarac t
13 5 Other extrac apsular extrac tion of lens
13 51 E xtrac apsular extrac tion of lens by temporal inferior route

13 59 Other extrac apsular extrac tion of lens
13 6 Other c atarac t extrac tion
13 64 Disc ission of sec ondary membrane [after c atarac t]
13 65 E xc ision of sec ondary membrane [after c atarac t] C apsulec tomy
13 66 Mec hanic al fragmentation of sec ondary membrane [after c atarac t]
13 69 Other c atarac t extrac tion
13 7 Insertion of prosthetic lens [pseudophakos]
Excludes: implantation of intraocular telescope prosthesis (13.91)
13 70 Insertion of pseudophakos not otherwise spec ified
13 71 Insertion of intraoc ular lens prosthesis at time of c atarac t
extrac tion one - stage
Code also synchronous extraction of cataract (13.11- 13.69)
13 72 ec ondary insertion of intraoc ular lens prosthesis
13 8 R emoval of implanted lens
Removal of pseudophakos
13 9 Other operations on lens
13 90 Operation on lens Not E lsewhere C lassified
13 91 Implantation of intraoc ular telesc ope prosthesis
Implantable miniature telescope
Includes removal of lens, any method
Excludes: secondary insertion of ocular implant (16.61)
14 Operations on retina choroid vitreous and posterior
chamber
14 0 R emoval of foreign body from posterior segment of eye
Excludes: removal of surgically implanted material (14.6)
14 00 R emoval of foreign body from posterior segment of eye not
otherwise spec ified
14 01 R emoval of foreign body from posterior segment of eye with use of
magnet
14 02 R emoval of foreign body from posterior segment of eye without use
of magnet
14 1 Diagnostic proc edures on retina c horoid vitreous and posterior
c hamber
14 11 Diagnostic aspiration of vitreous
14 19 Other diagnostic proc edures on retina c horoid vitreous and
posterior c hamber

digit required 47
14 2 Destruc tion of lesion of retina and c horoid
Includes: destruction of chorioretinopathy or isolated chorioretinal lesion
Excludes: that for repair of retina (14.31-14.59)
14 21 Destruc tion of c horioretinal lesion by diathermy
14 22 Destruc tion of c horioretinal lesion by c ryotherapy
14 23 Destruc tion of c horioretinal lesion by xenon arc photoc oagulation
14 24 Destruc tion of c horioretinal lesion by laser photoc oagulation
14 25 Destruc tion of c horioretinal lesion by photoc oagulation of
unspec ified type
14 26 Destruc tion of c horioretinal lesion by radiation therapy
14 27 Destruc tion of c horioretinal lesion by implantation of radiation
sourc e
14 29 Other destruc tion of c horioretinal lesion
Destruction of lesion of retina and choroid NOS
14 3 R epair of retinal tear
Includes: repair of retinal defect
Excludes: repair of retinal detachment (14.41-14.59)
14 31 R epair of retinal tear by diathermy
14 32 R epair of retinal tear by c ryotherapy
14 33 R epair of retinal tear by xenon arc photoc oagulation
14 34 R epair of retinal tear by laser photoc oagulation
14 35 R epair of retinal tear by photoc oagulation of unspec ified type
14 39 Other repair of retinal tear
14 4 R epair of retinal detac hment with sc leral buc kling and implant
14 41 c leral buc kling with implant
14 49 Other sc leral buc kling
Scleral buckling with:
air tamponade
resection of sclera
vitrectomy
14 5 Other repair of retinal detac hment
Includes: that with drainage
14 51 R epair of retinal detac hment with diathermy
14 52 R epair of retinal detac hment with c ryotherapy
14 53 R epair of retinal detac hment with xenon arc photoc oagulation
14 54 R epair of retinal detac hment with laser photoc oagulation
14 55 R epair of retinal detac hment with photoc oagulation of
unspec ified type
14 59 Other
14 6 R emoval of surgic ally implanted material from posterior
segment of eye

14 7 Operations on vitreous
14 71 R emoval of vitreous anterior approac h
Open sky technique
Removal of vitreous, anterior approach (with replacement)
14 72 Other removal of vitreous
Aspiration of vitreous by posterior sclerotomy
14 73 Mec hanic al vitrec tomy by anterior approac h
14 74 Other mec hanic al vitrec tomy
Posterior approach
14 75 Injec tion of vitreous substitute
Excludes: that associated with removal (14.71-14.72)
14 79 Other operations on vitreous
14 9 Other operations on retina c horoid and posterior c hamber
15 Operations on extraocular muscles
15 0 Diagnostic proc edures on extraoc ular musc les or tendons
15 01 iopsy of extraoc ular musc le or tendon
15 09 Other diagnostic proc edures on extraoc ular musc les and tendons
15 1 Operations on one extraoc ular musc le involving temporary
detac hment from globe
15 11 R ec ession of one extraoc ular musc le
15 12 Advanc ement of one extraoc ular musc le
15 13 R esec tion of one extraoc ular musc le
15 19 Other operations on one extraoc ular musc le involving temporary
detac hment from globe
Excludes: transposition of muscle (15.5)
15 2 Other operations on one extraoc ular musc le
15 21 L engthening proc edure on one extraoc ular musc le
15 22 hortening proc edure on one extraoc ular musc le
15 29 Other
15 3 Operations on two or more extraoc ular musc les involving
temporary detac hment from globe one or both eyes
15 4 Other operations on two or more extraoc ular musc les one or
both eyes
15 5 Transposition of extraoc ular musc les
Excludes: that for correction of ptosis (08.31-08.36)
15 6 R evision of extraoc ular musc le surgery

digit required 49
15 7 R epair of injury of extraoc ular musc le
Freeing of entrapped extraocular muscle
Lysis of adhesions of extraocular muscle
Repair of laceration of extraocular muscle, tendon, or Tenon's capsule
15 9 Other operations on extraoc ular musc les and tendons
16 Operations on orbit and eyeball
Excludes: reduction of fracture of orbit (76.78-76.79)
16 0 Orbitotomy
16 01 Orbitotomy with bone flap
Orbitotomy with lateral approach
16 02 Orbitotomy with insertion of orbital implant
Excludes: that with bone flap (16.01)
16 09 Other orbitotomy
16 1 R emoval of penetrating foreign body from eye not otherwise
spec ified
Excludes: removal of nonpenetrating foreign body (98.21)
16 2 Diagnostic proc edures on orbit and eyeball
16 21 Ophthalmosc opy
16 22 Diagnostic aspiration of orbit
16 23 iopsy of eyeball and orbit
16 29 Other diagnostic proc edures on orbit and eyeball
Excludes: examination of form and structure of eye (95.11-95.16)
general and subjective eye examination (95.01-95.09)
microscopic examination of specimen from eye (90.21-90.29)
objective functional tests of eye (95.21-95.26)
ocular thermography (88.82)
tonometry (89.11)
x-ray of orbit (87.14, 87.16)
16 3 E visc eration of eyeball
16 31 R emoval of oc ular c ontents with sync hronous implant into sc leral
shell
16 39 Other evisc eration of eyeball
16 4 E nuc leation of eyeball
16 41 E nuc leation of eyeball with sync hronous implant into Tenon's
c apsule with attac hment of musc les
Integrated implant of eyeball
16 42 E nuc leation of eyeball with other sync hronous implant
16 49 Other enuc leation of eyeball
Removal of eyeball NOS
16 5 E xenteration of orbital c ontents
16 51 E xenteration of orbit with removal of adjac ent struc tures
Radical orbitomaxillectomy

16 52 E xenteration of orbit with therapeutic removal of orbital bone
16 59 Other exenteration of orbit
Evisceration of orbit NOS
Exenteration of orbit with temporalis muscle transplant
16 6 ec ondary proc edures after removal of eyeball
Excludes: that with synchronous:
enucleation of eyeball (16.41-16.42)
evisceration of eyeball (16.31)
16 61 ec ondary insertion of oc ular implant
16 62 R evision and reinsertion of oc ular implant
16 63 R evision of enuc leation soc ket with graft
16 64 Other revision of enuc leation soc ket
16 65 ec ondary graft to exenteration c avity
16 66 Other revision of exenteration c avity
16 69 Other sec ondary proc edures after removal of eyeball
16 7 R emoval of oc ular or orbital implant
16 71 R emoval of oc ular implant
16 72 R emoval of orbital implant
16 8 R epair of injury of eyeball and orbit
16 81 R epair of wound of orbit
Excludes: reduction of orbital fracture (76.78-76.79)
repair of extraocular muscles (15.7)
16 82 R epair of rupture of eyeball
Repair of multiple structures of eye
Excludes: repair of laceration of:
cornea (11.51-11.59)
sclera (12.81)
16 89 Other repair of injury of eyeball or orbit
16 9 Other operations on orbit and eyeball
Excludes: irrigation of eye (96.51)
prescription and fitting of low vision aids (95.31-95.33)
removal of:
eye prosthesis NEC (97.31)
nonpenetrating foreign body from eye without incision (98.21)
16 91 R etrobulbar injec tion of therapeutic agent
Excludes: injection of radiographic contrast material (87.14)
opticociliary injection (12.79)
16 92 E xc ision of lesion of orbit
Excludes: biopsy of orbit (16.23)
16 93 E xc ision of lesion of eye unspec ified struc ture
Excludes: biopsy of eye NOS (16.23)
16 98 Other operations on orbit
16 99 Other operations on eyeball

17 41 Open robotic assisted proc edure
Robotic assistance in open procedure
17 42 L aparosc opic robotic assisted proc edure
Robotic assistance in laparoscopic procedure
17 43 P erc utaneous robotic assisted proc edure
Robotic assistance in percutaneous procedure
17 44 E ndosc opic robotic assisted proc edure
Robotic assistance in endoscopic procedure
17 45 Thorac osc opic robotic assisted proc edure
Robotic assistance in thoracoscopic procedure
17 49 Other and unspec ified robotic assisted proc edure
Robotic assistance in other and unspecified procedure
Excludes: endoscopic robotic assisted procedure (17.44)
laparoscopic robotic assisted procedure (17.42)
open robotic assisted procedure (17.41)
percutaneous robotic assisted procedure (17.43)
thoracoscopic robotic assisted procedure (17.45)
17 5 Additional c ardiovasc ular proc edures
17 51 Implantation of rec hargeable c ardiac c ontrac tility modulation
[C C M] total system
Implantation of CCM system includes formation of pocket,
transvenous leads, including placement of leads, placement of
catheter into left ventricle, intraoperative procedures for
evaluation of lead signals, obtaining sensing threshold
measurements, obtaining defibrillator threshold measurements.
Includes implantation of device with removal of existing device
Code also any concomitant:
coronary bypass (36.10 36.19)
extracorporeal circulation (39.61)
insertion or replacement of automatic cardioverter/defibrillator,
total system [AICD] (37.94)
Excludes: implantation of CCM pulse generator only (17.52)
17 52 Implantation or replac ement of c ardiac c ontrac tility modulation
[C C M] rec hargeable pulse generator only
Implantation of CCM device with removal of any existing CCM
device
Code also any concomitant:
revision of device pocket (37.79)
revision of lead [electrode] (37.75)

OTHER MISCELLANEOUS DIAGNOSTIC AND THERAPEUTIC PROCEDURES (17)
digit required 53
17 6 L aser interstitial thermal therapy [L ITT] under guidanc e
Focused laser interstitial thermal therapy [f- LITT] under MRI guidance
MRI- guided LITT
17 61 L aser interstitial thermal therapy [L ITT] of lesion or tissue of
brain under guidanc e
Focused laser interstitial thermal therapy [f- LITT] under MRI
guidance
MRI- guided LITT of lesion or tissue of brain
Excludes: laser interstitial thermal therapy [LITT] of lesion of
tissue of head under guidance (17.62)
head and nec k under guidanc e
guidance
MRI- guided LITT of lesion or tissue of head and neck
Excludes: laser interstitial thermal therapy [LITT] of lesion or
tissue of brain under guidance (17.61)
liver under guidanc e
guidance
MRI- guided LITT of lesion or tissue of liver
other and unspec ified site under guidanc e
guidance
MRI- guided LITT of lesion or tissue of breast
MRI- guided LITT of lesion or tissue of lung
MRI- guided LITT of lesion or tissue of prostate
Excludes: laser interstitial thermal therapy [LITT] of lesion or tissue
of brain under guidance (17.61)
laser interstitial thermal therapy [LITT] of lesion or tissue
of head and neck under guidance (17.62)
laser interstitial thermal therapy [LITT] of lesion or tissue
of liver under guidance (17.63)
17 7 Other diagnostic and therapeutic proc edures
17 70 Intravenous infusion of c lofarabine
Excludes: injection or infusion of cancer chemotherapeutic
substance (99.25)

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ICD-9-CM Procedures (Ophthalmic Only).pdf