How To Use CPT Code 67413

CPT 67413 describes a specific procedure that involves the removal of a foreign body from the orbit without the creation of a bone flap. This article will provide an overview of CPT code 67413, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 67413?

CPT 67413 is a code used to describe a procedure in which a healthcare provider removes a foreign body from the orbit without creating a bone flap. This procedure involves making an incision in the eyelid or through the conjunctival membrane covering the eye to access and extract the foreign object. It is important to note that this code specifically refers to cases where a bone flap is not created.

2. Official Description

The official description of CPT code 67413 is: ‘Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body.’

3. Procedure

1. During the procedure, the healthcare provider makes a small incision in the eyelid below the lashes or incises the conjunctiva.
2. The incision is extended through the caruncle over the infraorbital rim by everting the lower lid.
3. The provider identifies and extracts the foreign body from the orbit.
4. The conjunctiva is reattached, and the area is irrigated to ensure cleanliness.
5. The provider checks for any bleeding, removes any instruments used during the procedure, and closes the incision.

4. Qualifying circumstances

CPT code 67413 is used when a foreign body needs to be removed from the orbit without the creation of a bone flap. This procedure is typically performed when there is a foreign object present in the orbit that requires extraction. It is important to note that this code specifically refers to cases where a bone flap is not created.

5. When to use CPT code 67413

CPT code 67413 should be used when a healthcare provider performs an orbitotomy without creating a bone flap and removes a foreign body from the orbit. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT code 67413, the healthcare provider must document the following information:

• Patient’s diagnosis and the presence of a foreign body in the orbit
• Details of the procedure, including the approach used (frontal or transconjunctival)
• Description of the foreign body and its location within the orbit
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 67413, it is important to ensure that the procedure meets the specific criteria outlined in the code description. This includes performing an orbitotomy without creating a bone flap and removing a foreign body from the orbit. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT code 67413 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 healthcare provider performs an orbitotomy without creating a bone flap and removes a metal shard from the orbit of a patient.
2. During a procedure, a foreign body, a small piece of glass, is extracted from the orbit without the creation of a bone flap.
3. A healthcare provider removes a bone fragment from the orbit without creating a bone flap during an orbitotomy procedure.
4. Using a transconjunctival approach, a healthcare provider removes a wooden splinter from the orbit without creating a bone flap.
5. A patient undergoes an orbitotomy without bone flap creation, and a plastic foreign body is successfully removed from the orbit.
6. A healthcare provider performs an orbitotomy without creating a bone flap and removes a small stone from the orbit of a patient.
7. During a procedure, a healthcare provider removes a metal fragment from the orbit without the creation of a bone flap.
8. A foreign body, a glass shard, is successfully extracted from the orbit without the creation of a bone flap during an orbitotomy procedure.
9. A healthcare provider removes a bone fragment from the orbit without creating a bone flap during an orbitotomy procedure.
10. Using a frontal approach, a healthcare provider removes a wooden splinter from the orbit without creating a bone flap.