How To Use CPT Code 67560

CPT 67560 describes the removal or revision of an orbital implant that is located outside of the muscle cone. 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 67560?

CPT 67560 can be used to describe the removal or revision of a previously placed prosthetic eyeball that is located outside of the muscle cone. This code is used when the implant needs to be removed or revised due to poor fit or function.

2. Official Description

The official description of CPT code 67560 is: ‘Orbital implant (implant outside muscle cone); removal or revision.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. The provider revises the orbital implant by stitching the muscle ends of the eye to the implant, allowing the muscles to move the implant.
3. The provider brings the conjunctiva, the transparent membrane covering the front of the eye and lining the eyelids, across the front of the orbital implant and sutures it in place.
4. If necessary, the provider may completely remove the implant.

4. Qualifying circumstances

Patients eligible for CPT 67560 are those who have a previously placed orbital implant located outside of the muscle cone that requires removal or revision. The procedure is performed by a qualified healthcare provider. The implant may need to be removed or revised due to poor fit or function.

5. When to use CPT code 67560

CPT code 67560 should be used when a previously placed orbital implant located outside of the muscle cone needs to be removed or revised. This code should not be used for the initial insertion of an orbital implant.

6. Documentation requirements

To support a claim for CPT 67560, the healthcare provider must document the following information:

• Reason for removal or revision of the orbital implant
• Details of the procedure performed, including any stitching of muscle ends and suturing of the conjunctiva
• Date of the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 67560, ensure that the procedure involves the removal or revision of an orbital implant located outside of the muscle cone. It is important to follow the specific documentation requirements for this code. CPT code 67560 should not be reported with other codes unless necessary.

8. Historical information

CPT 67560 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 a revision of a previously placed orbital implant due to discomfort and poor fit.
2. The provider removes an orbital implant that has become infected and is causing complications.
3. A patient’s orbital implant needs to be revised to improve movement and alignment of the eye.
4. The provider removes a malfunctioning orbital implant and replaces it with a new one.
5. An orbital implant is removed due to patient preference and dissatisfaction with the appearance.
6. The provider revises an orbital implant to correct asymmetry and improve the patient’s overall facial appearance.
7. A patient’s orbital implant needs to be removed due to an allergic reaction.
8. The provider performs a revision of an orbital implant to address a change in the patient’s eye socket shape.
9. An orbital implant is removed and replaced with a larger size to achieve better aesthetic results.
10. The provider revises an orbital implant to improve the patient’s ability to move their eye.