How To Use CPT Code 67405

CPT 67405 describes a specific procedure used to drain an abscess or other fluid accumulation in the orbit without creating a bone flap. 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 67405?

CPT 67405 is a code used to describe a procedure where the provider makes an incision in the orbit without creating a bone flap to drain an abscess or other fluid accumulation caused by infection or cysts. This procedure is performed in the eye area and is used to alleviate the symptoms and complications associated with the fluid accumulation.

2. Official Description

The official description of CPT code 67405 is: ‘Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only.’

3. Procedure

1. After appropriate preparation and anesthesia, the provider makes a small incision in the upper eyelid crease or over the infraorbital rim, depending on the approach chosen.
2. The provider identifies any abscesses or cysts in the orbit and proceeds to drain the fluid accumulation.
3. The area is then irrigated, checked for bleeding, and any instruments used are removed.
4. Finally, the incision is closed to complete the procedure.

4. Qualifying circumstances

CPT 67405 is used when there is a need to drain an abscess or fluid accumulation in the orbit due to infection or cysts. The procedure is performed by making an incision in the eye area without creating a bone flap. It is important to note that this procedure is only performed when there is a specific medical necessity for drainage.

5. When to use CPT code 67405

CPT code 67405 should be used when a provider performs an orbitotomy without a bone flap to drain an abscess or fluid accumulation in the orbit. It is important to ensure that the procedure is performed solely for drainage purposes and not for exploration or biopsy. If the procedure involves exploration without drainage, a different code should be used.

6. Documentation requirements

To support a claim for CPT 67405, the provider must document the following information:

• The reason for the procedure, such as the presence of an abscess or fluid accumulation
• The specific approach used (frontal or transconjunctival)
• The date of the procedure
• Details of the procedure, including the incision site and the drainage performed
• Any complications or additional procedures performed
• The provider’s signature

7. Billing guidelines

When billing for CPT 67405, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The procedure should be performed without creating a bone flap and solely for drainage purposes. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 67405 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 provider performs an orbitotomy without a bone flap to drain an abscess in the orbit caused by infection.
2. A patient presents with a fluid accumulation in the orbit due to cysts, and the provider performs an orbitotomy without a bone flap to drain the fluid.
3. An individual develops an abscess in the orbit, and the provider performs an orbitotomy without a bone flap to drain the abscess and alleviate symptoms.
4. A patient experiences complications from a fluid accumulation in the orbit, and the provider performs an orbitotomy without a bone flap to drain the fluid and improve the patient’s condition.
5. A provider performs an orbitotomy without a bone flap to drain an abscess in the orbit caused by an infection, preventing further complications.