How To Use CPT Code 68020

CPT 68020 describes the procedure of incision of the conjunctiva and drainage of a cyst. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 68020?

CPT 68020 is a code used to describe the procedure of incision of the conjunctiva and drainage of a cyst. It involves making an incision into the mucous membrane that lines the inner surface of the eyelid and draining the contents of the cyst to relieve pressure.

2. Official Description

The official description of CPT code 68020 is: ‘Incision of conjunctiva, drainage of cyst.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The healthcare provider makes an incision into the conjunctiva, which is the mucous membrane that lines the inner surface of the eyelid.
3. The provider gains access to the cyst by incising the affected lining of the eyelid.
4. A small needle is then used to puncture the cyst and drain its contents.

4. Qualifying circumstances

CPT 68020 is performed when a patient has a cyst that requires drainage to relieve pressure. The procedure is typically performed by a healthcare provider who is trained in ophthalmology or oculoplastic surgery.

5. When to use CPT code 68020

CPT code 68020 should be used when a healthcare provider performs the incision of the conjunctiva and drainage of a cyst procedure. It is important to ensure that the procedure is medically necessary and meets the criteria for reimbursement.

6. Documentation requirements

To support a claim for CPT 68020, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the procedure
• Date of the procedure
• Details of the procedure, including the incision made and the drainage of the cyst
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 68020, ensure that the procedure meets the criteria for reimbursement. It is important to follow the specific guidelines set forth by the payer and to use the appropriate modifiers, if necessary. It is also important to document any additional procedures performed during the same visit.

8. Historical information

CPT 68020 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 presents with a cyst on their eyelid, causing discomfort and vision impairment. The healthcare provider performs an incision of the conjunctiva and drains the cyst to relieve pressure.
2. During a routine eye examination, the healthcare provider discovers a cyst on the patient’s conjunctiva. The provider decides to perform an incision and drainage procedure to alleviate the patient’s symptoms.
3. A patient with a history of recurrent cysts on their eyelid comes in for a follow-up visit. The healthcare provider decides to perform an incision of the conjunctiva and drain the cyst to prevent further complications.
4. A patient presents with a large cyst on their conjunctiva, causing significant discomfort and affecting their vision. The healthcare provider determines that an incision and drainage procedure is necessary to alleviate the patient’s symptoms.
5. During a routine eye examination, the healthcare provider discovers a cyst on the patient’s conjunctiva. The provider decides to perform an incision and drainage procedure to prevent the cyst from growing larger and causing more severe symptoms.
6. A patient with a history of recurring cysts on their eyelid comes in for a consultation. The healthcare provider recommends an incision and drainage procedure to alleviate the patient’s symptoms and prevent future cyst formation.
7. A patient presents with a painful cyst on their conjunctiva. The healthcare provider determines that an incision and drainage procedure is necessary to relieve the patient’s pain and improve their vision.
8. During a routine eye examination, the healthcare provider discovers a cyst on the patient’s conjunctiva. The provider decides to perform an incision and drainage procedure to prevent the cyst from causing further complications and discomfort.
9. A patient with a history of recurrent cysts on their eyelid comes in for a follow-up visit. The healthcare provider decides to perform an incision of the conjunctiva and drain the cyst to alleviate the patient’s symptoms and prevent future cyst formation.
10. A patient presents with a large cyst on their conjunctiva, causing significant discomfort and affecting their vision. The healthcare provider determines that an incision and drainage procedure is necessary to alleviate the patient’s symptoms and improve their quality of life.