How To Use CPT Code 67950

CPT 67950 describes a surgical procedure known as canthoplasty, which involves the reconstruction of the canthus, specifically the lateral canthal tendon or orbicularis muscle at the outer corner of the eyelids. This article will provide an overview of CPT code 67950, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 67950?

CPT 67950 is a code used to describe the surgical procedure known as canthoplasty. This procedure is performed by an ophthalmologist to strengthen the lateral canthal tendon or orbicularis muscle at the outer corner of the eyelids. Canthoplasty provides support to the outer corner of the eyelid and can also involve reshaping the eye. It is sometimes used to prevent ectropion problems as well.

2. Official Description

The official description of CPT code 67950 is: ‘Canthoplasty (reconstruction of canthus).’ This code encompasses the surgical procedure performed by an ophthalmologist to strengthen the lateral canthal tendon or orbicularis muscle at the outer corner of the eyelids.

3. Procedure

1. The procedure begins with the administration of anesthesia to the patient.
2. An incision is made in the outer corner of the eyelid/canthal area.
3. A full thickness lateral canthotomy is performed using scissors.
4. During the procedure, the lateral canthal tendon and lateral orbital septum may also be released.
5. The physician may remove lashes, follicles, and other attachments from the lid margin if necessary.
6. The eyelid is then adjusted for reattachment to align it properly.
7. The conjunctiva is mobilized and sutured to the new canthal area using a double arm suture.
8. A rubber peg may be used for support during the tying of the suture.

4. Qualifying circumstances

CPT 67950 is performed by an ophthalmologist to strengthen the lateral canthal tendon or orbicularis muscle at the outer corner of the eyelids. This procedure is typically indicated for patients who require support to the outer corner of the eyelid or reshaping of the eye. It may also be used to prevent ectropion problems. The specific circumstances for performing canthoplasty should be determined by the ophthalmologist based on the patient’s condition and needs.

5. When to use CPT code 67950

CPT code 67950 should be used when an ophthalmologist performs canthoplasty to reconstruct the canthus, specifically the lateral canthal tendon or orbicularis muscle at the outer corner of the eyelids. This code is appropriate for reporting the surgical procedure itself and should be used when documenting and billing for this specific service.

6. Documentation requirements

When documenting a claim for CPT code 67950, the ophthalmologist should include the following information:

• Patient’s diagnosis and the need for canthoplasty
• Details of the procedure performed, including any additional steps or modifications
• Date of the procedure
• Start and end time of the procedure
• Any specific findings or complications encountered during the procedure
• Any additional procedures or services performed in conjunction with canthoplasty
• Signature of the ophthalmologist performing the procedure

7. Billing guidelines

When billing for CPT code 67950, it is important to ensure that the procedure is performed by an ophthalmologist and that the documentation supports the need for canthoplasty. This code should be reported for the surgical procedure itself and should not be reported with other codes unless additional procedures or services are performed in conjunction with canthoplasty. Modifier 58 (Staged or related procedure or service by the same physician during the postoperative period) may be appended to indicate a staged procedure if applicable.

8. Historical information

CPT code 67950 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. An ophthalmologist performs canthoplasty to strengthen the lateral canthal tendon for a patient with weakened eyelid support.
2. Canthoplasty is performed by an ophthalmologist to reshape the eye and provide support to the outer corner of the eyelid for a patient with aesthetic concerns.
3. An ophthalmologist performs canthoplasty to prevent ectropion problems in a patient with a history of eyelid malposition.
4. Canthoplasty is performed by an ophthalmologist to address eyelid laxity and improve the overall appearance of the eye for a patient seeking cosmetic enhancement.
5. An ophthalmologist performs canthoplasty to correct eyelid asymmetry and provide better alignment for a patient with functional concerns.
6. Canthoplasty is performed by an ophthalmologist to address eyelid malposition and improve the patient’s ability to close their eyes properly.
7. An ophthalmologist performs canthoplasty to provide support to the outer corner of the eyelid and prevent further complications for a patient with a history of eyelid trauma.
8. Canthoplasty is performed by an ophthalmologist to enhance the overall appearance of the eye and improve the patient’s self-confidence.
9. An ophthalmologist performs canthoplasty to correct eyelid laxity and improve the patient’s field of vision.