How To Use CPT Code 67916

CPT 67916 describes the repair of ectropion using tarsal wedge excision. 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 67916?

CPT 67916 is used to describe the surgical repair of ectropion, a condition where the lower eyelid and eyelashes turn outward. This procedure involves the removal of a section of tissue from the posterior surface of the lower eyelid, known as the tarsus. By excising this wedge-shaped tissue, the provider aims to correct the ectropion and alleviate symptoms such as excessive tearing and eye irritation.

2. Official Description

The official description of CPT code 67916 is: ‘Repair of ectropion; excision tarsal wedge.’

3. Procedure

1. After appropriate preparation and anesthesia, the provider makes an incision at the lower eyelid.
2. A section of tissue from the posterior surface of the lower eyelid, known as the tarsus, is removed.
3. The incision is then closed using sutures.

4. Qualifying circumstances

CPT 67916 is performed when a patient presents with ectropion, a condition characterized by the outward turning of the lower eyelid and eyelashes. This procedure is suitable for patients experiencing symptoms such as excessive tearing and eye irritation. It is important to note that the repair of ectropion using tarsal wedge excision should be performed by a qualified healthcare professional.

5. When to use CPT code 67916

CPT code 67916 should be used when a provider performs the surgical repair of ectropion using tarsal wedge excision. This code accurately represents the specific procedure and allows for proper billing and documentation.

6. Documentation requirements

To support a claim for CPT 67916, the provider must document the following information:

• Patient’s diagnosis of ectropion
• Description of the procedure performed, including tarsal wedge excision
• Date of the procedure
• Any additional relevant details or findings
• Signature of the performing healthcare professional

7. Billing guidelines

When billing for CPT 67916, ensure that the procedure was performed by a qualified healthcare professional. It is important to follow the specific guidelines and requirements set forth by the payer. Additionally, consider any applicable modifiers or additional codes that may need to be reported in conjunction with CPT 67916.

8. Historical information

CPT code 67916 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 patient presents with ectropion, and the provider performs tarsal wedge excision to repair the condition.
2. During a surgical procedure, the provider identifies ectropion and decides to perform tarsal wedge excision to correct the eyelid malposition.
3. A patient with symptomatic ectropion undergoes tarsal wedge excision as a surgical intervention.
4. After a thorough evaluation, the provider determines that tarsal wedge excision is the most appropriate surgical approach to repair the patient’s ectropion.
5. During a routine eye examination, the provider diagnoses ectropion and recommends tarsal wedge excision to address the condition.
6. A patient seeks treatment for chronic eye irritation, and the provider determines that tarsal wedge excision is necessary to correct the underlying ectropion.
7. Following a comprehensive assessment, the provider recommends tarsal wedge excision as the optimal surgical solution for the patient’s ectropion.
8. A patient with ectropion undergoes tarsal wedge excision to improve their eyelid position and alleviate symptoms.
9. The provider performs tarsal wedge excision to repair the ectropion, ensuring proper alignment of the lower eyelid.
10. After discussing the available treatment options, the patient opts for tarsal wedge excision to correct their ectropion.