5.18: CPC Exam: Eye and Ocular Adnexa

In this video, we’ll cover the eye and ocular adnexa as it relates to the CPC exam. You’ll find a breakdown of the eye and its surrounding muscles and glands, and tips for preparation for the test.

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5.18: CPC Exam: Eye and Ocular Adnexa

Codes for the eye and ocular adnexa are found in the 65091 – 68899 numerical range of the CPT manual, toward the very end of the Surgery section.

“Adnexa” refers to the parts of the body adjoining the organ, so the subsection on the eye and ocular adnexa includes procedures on the eye itself in addition to the ocular muscles and eyelids. This subsection also includes the conjunctiva and lacrimal system, which line and protect the eye.

The eye is made up of the cornea, anterior chamber, iris, lens, vitreous humor (a colorless mass that makes up the bulk of the eyeball), retina, and the optic nerve. It’s supported by four primary muscles and two oblique muscles. The horizontally oriented muscles are the medial rectus and the lateral rectus, and the vertical muscles are the superior and the inferior rectus. There is also the inferior and superior oblique muscles, which aid in eye rotation and elevation. Exterior to the eye are the eyelids and lacrimal system (tear ducts).

The first portion of the eye and ocular adnexa subsection focuses on procedures of the eyeball itself. Here you’ll find codes for removal and repair of the eye, and also implants. Note that an “ocular implant” occurs inside the muscular cone of the eye (inside the set of muscles listed above, including inside the eye) and an “orbital implant” occurs outside the muscular cone. Recall that the orbit of the skull is the cavity where the eye is situated.

The anterior segment of the eye is next. The anterior section of the eye encompasses the lens, cornea, conjunctiva (the membrane that coats the eye), iris, and ciliary body. In other words the front (‘anterior’) of the eye. The vast majority of procedures live here, including keratoplasties (cornea transplants), repairs for the iris and ciliary body, and various procedures on the lens.

The posterior segment section includes procedures on the retina and vitreous, including repairs for retinal detachment. Finally, the ocular adnexa section features procedures for the repair, adjustment, excision and exploration of the ocular muscles, which we talked about above. In the ocular adnexa section you’ll also find codes for procedures on the eyelid.

Finally, the conjunctiva section includes procedures on the conjunctiva and lacrimal system, which includes the lacrimal sac and ducts. Here you’ll find codes for incisions, drainages, and grafts for the conjunctiva, along with repairs and exploratory procedures of the lacrimal gland.

The eye and ocular adnexa subsection of Surgery is relatively brief, but don’t be surprised if you see a question or two on the exam covering it. Know your vocabulary terms and it should be easy to pick out the right answer.

Video: CPC Exam: Eye and Ocular Adnexa

In this video, we’ll cover the eye and ocular adnexa as it relates to the CPC exam. You’ll find a breakdown of the eye and its surrounding muscles and glands, and tips for preparation for the test.