How To Use CPT Code 67414

CPT 67414 describes a specific procedure known as orbitotomy without bone flap. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 67414?

CPT 67414 is used to describe a procedure called orbitotomy without bone flap. This procedure involves making an incision in the orbit, the bony cavity that holds the eyes, to relieve pressure on other structures. Unlike other approaches, no bone flap is created during this procedure.

2. Official Description

The official description of CPT code 67414 is: ‘Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression.’

3. Procedure

1. During the procedure, the provider makes a small incision in the eyelid or through the conjunctival membrane covering the eye.
2. The provider explores the orbit to identify the area of compression.
3. Using a drill, the provider removes sufficient bony tissue to relieve the pressure on other structures.
4. The provider reattaches the conjunctiva and irrigates the area.
5. After checking for bleeding and removing any instruments, the provider closes the incision.

4. Qualifying circumstances

CPT 67414 is used when a patient requires orbitotomy without bone flap for decompression. This procedure is typically performed to relieve pressure on other structures in the orbit. It is important to note that this code specifically refers to the removal of bone for decompression and does not involve the creation of a bone flap.

5. When to use CPT code 67414

CPT code 67414 should be used when a provider performs orbitotomy without bone flap for decompression. 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 code 67414, the provider must document the following information:

• Patient’s diagnosis and the need for orbitotomy without bone flap
• Details of the procedure, including the approach used (frontal or transconjunctival)
• Specific bone removal for decompression
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 67414, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the procedure and any additional services provided. Review the guidelines provided by the payer to ensure proper billing and reimbursement.

8. Historical information

CPT code 67414 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs orbitotomy without bone flap for decompression on a patient with orbital pressure due to a tumor.
2. During the procedure, the provider removes bone to relieve pressure on the optic nerve in a patient with orbital compartment syndrome.
3. A patient with Graves’ disease undergoes orbitotomy without bone flap for decompression to alleviate pressure on the eye.
4. A provider performs orbitotomy without bone flap for decompression on a patient with a traumatic orbital fracture.
5. During the procedure, the provider removes bone to relieve pressure on the ocular adnexa in a patient with orbital cellulitis.
6. A patient with a retrobulbar hematoma undergoes orbitotomy without bone flap for decompression to alleviate pressure on the optic nerve.
7. A provider performs orbitotomy without bone flap for decompression on a patient with orbital inflammation due to an autoimmune disorder.
8. During the procedure, the provider removes bone to relieve pressure on the lacrimal gland in a patient with dacryoadenitis.
9. A patient with a foreign body in the orbit undergoes orbitotomy without bone flap for decompression and removal of the foreign body.
10. A provider performs orbitotomy without bone flap for decompression on a patient with orbital pseudotumor.