How To Use CPT Code 65110

CPT 65110 describes the removal of the contents of one side of the orbit, the bony socket that holds the eyes, without the application of a skin graft. 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 65110?

CPT 65110 can be used to describe the surgical procedure in which the provider removes the contents of one side of the orbit, the bony socket that holds the eyes. This procedure is typically performed due to trauma or disease of the eye, such as a tumor. It does not involve the application of a skin graft.

2. Official Description

The official description of CPT code 65110 is: ‘Exenteration of orbit (does not include skin graft), removal of orbital contents; only.’

3. Procedure

1. After appropriate prepping and anesthesia, the provider passes a suture through the eyelid skin and orbicularis, then through the tarsal plate to secure the lids together.
2. An incision is made close to the lid margin to spare the eyelids.
3. The provider separates the periorbita from the bone and continues until reaching the orbital apex.
4. At the orbital apex, the provider clamps the tissues, makes an incision, and extracts the contents of the orbit.
5. Dry gauze is placed in the orbit, and the wound is closed using sutures.
6. A pressure patch is applied to the closed wound.

4. Qualifying circumstances

CPT 65110 is performed when there is a need to remove the contents of the orbit due to trauma or disease of the eye, such as a tumor. It does not include the application of a skin graft. The procedure is typically performed by a qualified healthcare professional.

5. When to use CPT code 65110

CPT code 65110 should be used when the provider performs the removal of the contents of one side of the orbit without the application of a skin graft. It is important to accurately document the procedure and ensure that it meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 65110, the healthcare professional must document the following information:

• Reason for the procedure, such as trauma or disease of the eye
• Details of the procedure, including the specific steps taken
• Date of the procedure
• Any additional relevant information or complications
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 65110, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the procedure and any additional relevant information. Review the payer’s guidelines for any specific requirements or modifiers that may be necessary for proper billing.

8. Historical information

CPT 65110 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes CPT 65110 for the removal of orbital contents due to a tumor in the eye.
2. A provider performs CPT 65110 to remove the contents of the orbit following a traumatic injury to the eye.
3. CPT 65110 is used to remove the orbital contents in a patient with a severe eye infection.
4. A provider performs CPT 65110 to remove the contents of the orbit in a patient with a congenital eye disorder.
5. A patient undergoes CPT 65110 for the removal of orbital contents due to a non-cancerous growth in the eye.
6. CPT 65110 is used to remove the contents of the orbit in a patient with a rare eye disease.
7. A provider performs CPT 65110 to remove the orbital contents in a patient with a traumatic injury caused by a foreign object.
8. A patient undergoes CPT 65110 for the removal of orbital contents due to a malignant tumor in the eye.
9. CPT 65110 is used to remove the contents of the orbit in a patient with a chronic eye condition.
10. A provider performs CPT 65110 to remove the orbital contents in a patient with a recurrent eye infection.