In ophthalmology, PRP stands for panretinal photocoagulation a laser procedure used to treat retinal diseases like proliferative diabetic retinopathy and retinal vein occlusion. Knowing the correct CPT code for PRP is essential for accurate billing and timely reimbursement.
The proper code to report PRP in ophthalmology is:
CPT 67228 – Treatment of extensive or progressive retinopathy (e.g., diabetic retinopathy), photocoagulation.
This code should be billed per session and includes the laser treatment used to reduce or eliminate abnormal blood vessel growth in the retina.
You should bill CPT 67228 when:
Proper documentation is key. The patient’s diagnosis, retinal imaging, and treatment plan should support the use of this CPT code to avoid claim rejections.
Proper documentation is key. The patient’s diagnosis, retinal imaging, and treatment plan should support the use of this CPT code to avoid claim rejections. For detailed coding guidance, visit the American Academy of Ophthalmology’s CPT Coding Resource.
Using the right CPT code is critical not only for compliance but also for maximizing your reimbursement. Inaccurate billing of retinal procedures like PRP can result in claim denials, audits, or lost revenue. At EZSettle Solutions, we provide full-spectrum support for ophthalmology practices—from charge entry to payment posting. Our team ensures your claims meet payer-specific requirements and reduces errors before submission. To see how we can help you reduce billing errors, explore our ophthalmology medical billing services.
Beyond CPT coding, managing your revenue cycle efficiently is crucial for sustainable practice growth. Our revenue cycle management services include claims scrubbing, denial appeals, and reimbursement optimization.
Need help getting started? Request a free demo to discover how we streamline billing for specialty practices like yours.
For additional coding guidance on ophthalmic procedures like PRP, check the official American Academy of Ophthalmology CPT Coding Resource a leading source for ophthalmology-specific billing information.
The PRP CPT code (67228) is essential for accurate billing of retinal laser treatments. With the right documentation and a knowledgeable billing team, you can improve reimbursements and avoid costly denials. Let EZ Settle Solutions be your partner in precise ophthalmology billing.
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