CPT Code 67420 | Description & Clinical Information
CPT 67420 describes a surgical procedure in which the healthcare provider creates an incision through the side of the orbit, removes a segment of bone, either temporarily as a bone flap or as a bone window left open after the procedure, to gain access to an expanding tumor and remove it.
Official Description
The CPT book defines CPT code 67420 as: “Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion”.
Clinical Information
The procedure described by CPT code 67420 is a surgical intervention used to remove lesions in the orbital apex. This area is located at the topmost point of the orbital cavity, which houses the eyeball and its surrounding organs. Orbital apex lesions can cause visual impairment, pain, and other complications, so their prompt removal is crucial.
Performing this procedure requires careful preparation and attention to detail to minimize the risk of complications. First, the patient is appropriately prepped and anesthetized to ensure they are comfortable and safe throughout the procedure.
The provider then makes a small incision over the lateral canthus, a bony prominence on the side of the eye, to expose the upper and lower jaw bones as well as the cheekbone. From there, the provider removes the bone with a highspeed burr from the greater wing of sphenoid bone, a small bone on the side of the skull. The incision is extended along the deep lateral wall up to the supraorbital rim to identify the lesion and expose the orbital apex.
To minimize the risk of harm to surrounding areas, the provider takes great care to isolate the lesion from the surrounding tissues. Once the lesion is identified, it is meticulously removed. The provider then carefully returns the bone flap to its natural position and repairs the orbital roof or leaves a bone window and attaches a suction device to ensure any residual fluids are effectively removed.
As with all surgeries, the provider irrigates the area to ensure it remains clean, checks for any bleeding, removes any instruments, and then closes the incision in layers. Following the procedure, the patient is carefully monitored to ensure they are recovering well and on the path to healing.
In conclusion, while the procedure described by CPT code 67420 may seem complex, it is a critical intervention used to remove orbital apex lesions and prevent any harm to patients in need. With proper preparation, attention to detail, and postoperative care, patients can expect to recover fully from this surgery and regain their quality of life.
