Does 66982 require prior authorization?

No, 66982 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 66982?

Medicare facility rate: $630.61. Non-facility rate: $630.61. Work RVU: 9.99.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

9.99

Facility

$630.61

Non-Facility

$630.61

Submit complete medical documentation, including the operative note, that documents the specific complex technique(s) or device(s) used and the clinical circumstance justifying CPT 66982.
Include an initial supporting statement in the operative note explicitly stating the indication for complex cataract surgery (e.g., need to suture a posterior chamber IOL because of insufficient capsular support).
If a claim for CPT 66982 is denied, submit additional supporting information (including operative documentation) with the appeal request.
Ensure documentation also demonstrates compliance with any applicable Local Coverage Determination (LCD) requirements for cataract surgery.

Billing CPT 66982 is appropriate when insertion of iris retractors through additional incisions was required to perform the cataract extraction.
Billing CPT 66982 is appropriate when mechanical expansion of the pupil using hooks was required to complete the cataract surgery.
Billing CPT 66982 is appropriate when creation of a sector iridectomy with subsequent suture repair of the iris sphincter was necessary.
Billing CPT 66982 is appropriate when use of a Malyugin ring and multiple iris sphincterotomies with scissors were required.
Billing CPT 66982 is appropriate when permanent intraocular sutures were required to support the lens implant due to insufficient capsular support.
Billing CPT 66982 is appropriate when placement of a capsular support ring was necessary to allow secure intraocular lens placement.

L39905 — Cataract Surgery

J05

A59805 — Billing and Coding: Cataract Surgery

J05

L33558 — Cataract Extraction

J06

A56544 — Billing and Coding: Cataract Extraction

J06

A58592 — Billing and Coding: Cataract Extraction (including Complex Cataract Surgery)

Ask Verity about documentation requirements, denial risks, or coverage in your state.