How To Use CPT Code 67800

CPT 67800 describes the excision of a chalazion, a small nodule resulting from a blockage of an oil gland and ongoing inflammation. 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 67800?

CPT 67800 can be used to describe the excision of a chalazion, which is a small nodule that forms due to a blockage of an oil gland and chronic inflammation. This code is used when a healthcare provider removes the chalazion during a surgical procedure.

2. Official Description

The official description of CPT code 67800 is: ‘Excision of chalazion; single.’

3. Procedure

1. During the procedure, the healthcare provider prepares the patient and administers anesthesia.
2. The provider then uses chalazion forceps to grasp the lesion and pushes it aside.
3. A vertical incision is made into the lesion, allowing the provider to remove any debris and fibrous tissues.
4. After removing the clamp, the area is irrigated, checked for bleeding, and the incision is closed.
5. Finally, antibiotic ointment is applied to the area to prevent infection.

4. Qualifying circumstances

CPT 67800 is used when a patient has a chalazion that requires surgical excision. The patient may have experienced chronic inflammation and blockage of an oil gland, resulting in the formation of the chalazion. The procedure is performed by a healthcare provider who is qualified to perform surgical excisions.

5. When to use CPT code 67800

CPT code 67800 should be used when a healthcare provider performs a surgical excision of a chalazion. It is important to note that this code is specific to a single chalazion excision. If multiple chalazions are excised during the same procedure, additional codes may be required.

6. Documentation requirements

To support a claim for CPT 67800, the healthcare provider must document the following information:

• Patient’s diagnosis of chalazion
• Details of the procedure, including the use of anesthesia
• Incision technique and closure method
• Any complications or additional procedures performed
• Application of antibiotic ointment

7. Billing guidelines

When billing for CPT 67800, ensure that the procedure meets the criteria for chalazion excision. It is important to use the correct code for a single chalazion excision and not to report multiple chalazions under this code. Additionally, check payer requirements for any modifiers that may be necessary to designate the involved eyelid.

8. Historical information

CPT 67800 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 healthcare provider performs the excision of a chalazion on the upper eyelid of a patient.
2. During a surgical procedure, a chalazion on the lower eyelid of a patient is removed by a healthcare provider.
3. A patient presents with a chalazion on their right upper eyelid, and a healthcare provider performs the excision.
4. A healthcare provider excises a chalazion on the left lower eyelid of a patient during a surgical procedure.
5. During a chalazion excision, a healthcare provider removes a nodule from the upper eyelid of a patient.
6. A patient undergoes a surgical procedure to have a chalazion on their lower eyelid excised by a healthcare provider.
7. A healthcare provider performs the excision of a chalazion on the right lower eyelid of a patient.
8. During a surgical procedure, a chalazion on the left upper eyelid of a patient is removed by a healthcare provider.
9. A patient presents with a chalazion on their lower right eyelid, and a healthcare provider performs the excision.
10. A healthcare provider excises a chalazion on the upper left eyelid of a patient during a surgical procedure.