How To Use CPT Code 21282

CPT 21282 describes the procedure known as lateral canthopexy, which is performed to repair a damaged lateral canthal tendon and maintain the shape of the lower eyelid. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 21282?

CPT 21282 is used to describe the procedure of lateral canthopexy, which is performed to repair a damaged lateral canthal tendon. The lateral canthal tendon plays a crucial role in maintaining the shape and position of the lower eyelid. This procedure is typically performed by a healthcare provider to restore the normal function and appearance of the eyelid.

2. Official Description

The official description of CPT code 21282 is: ‘Repair of damaged lateral canthal tendon, including canthopexy; each eyelid.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The healthcare provider makes a small incision along the lower eyelid.
3. Two sutures are placed into the muscle, angled upward to engage the lateral canthal tendon and its surrounding retinaculum.
4. The sutures are passed up into the bony rim and tied to the periosteum lining the bone for support.
5. The incision is then closed.

4. Qualifying circumstances

CPT 21282 is performed when there is a damaged lateral canthal tendon that requires repair. This procedure is typically indicated for patients with conditions such as eyelid trauma or laxity, which can result in a weakened or damaged lateral canthal tendon. The healthcare provider must assess the patient’s condition and determine the need for lateral canthopexy.

5. When to use CPT code 21282

CPT code 21282 should be used when a healthcare provider performs a lateral canthopexy procedure to repair a damaged lateral canthal tendon. This code is specific to each eyelid, so it should be reported separately for each eyelid that undergoes the procedure.

6. Documentation requirements

To support a claim for CPT 21282, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for lateral canthopexy
• Details of the procedure, including the incision, sutures placed, and closure
• Any additional procedures performed in conjunction with lateral canthopexy
• Any complications or unexpected findings during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 21282, ensure that the procedure performed is a lateral canthopexy to repair a damaged lateral canthal tendon. This code should be reported separately for each eyelid that undergoes the procedure. If other procedures are performed in conjunction with lateral canthopexy, they should be reported separately using the appropriate CPT codes. Modifier 51, Multiple procedures, may be appended to each code if applicable.

8. Historical information

CPT 21282 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes lateral canthopexy on their right eyelid to repair a damaged lateral canthal tendon.
2. A healthcare provider performs lateral canthopexy on both eyelids of a patient with eyelid trauma.
3. A patient with eyelid laxity undergoes lateral canthopexy on their left eyelid to restore the normal function and appearance of the eyelid.
4. A healthcare provider performs lateral canthopexy on the right eyelid of a patient with a weakened lateral canthal tendon.
5. A patient undergoes lateral canthopexy on their left eyelid to address eyelid laxity caused by aging.
6. A healthcare provider performs lateral canthopexy on both eyelids of a patient with congenital eyelid abnormalities.
7. A patient with a damaged lateral canthal tendon undergoes lateral canthopexy on their right eyelid to improve eyelid stability.
8. A healthcare provider performs lateral canthopexy on the left eyelid of a patient with a history of eyelid trauma.
9. A patient undergoes lateral canthopexy on their right eyelid to correct eyelid malposition caused by a previous surgery.
10. A healthcare provider performs lateral canthopexy on both eyelids of a patient with eyelid laxity and ptosis.