How To Use CPT Code 68320

CPT 68320 describes a surgical procedure that involves the repair of the conjunctiva using the patient’s own conjunctival tissue as a graft or by rearranging the existing tissue. 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 68320?

CPT 68320 can be used to describe a surgical repair of the conjunctiva using the patient’s own conjunctival tissue as a graft or by rearranging the existing tissue. This procedure is typically performed to treat conditions such as conjunctivochalasis, which is characterized by excess folds of conjunctiva in the eye.

2. Official Description

The official description of CPT code 68320 is: ‘Conjunctivoplasty; with conjunctival graft or extensive rearrangement.’

3. Procedure

1. The provider performs a surgical repair of the conjunctiva using the patient’s own conjunctival tissue as a graft or by rearranging the existing tissue.
2. The procedure is typically done under local anesthesia, with the patient appropriately prepped and draped.
3. The provider identifies the areas of loose conjunctiva using an operating microscope or loupe magnification.
4. A small strip of conjunctiva is excised from the underlying tissue to allow relaxation of the loose tissue away from the cornea.
5. If possible, the provider sutures or glues the conjunctival margins together by extensively rearranging the existing tissue to close the wound.
6. If necessary, the provider prepares the wound location for the graft and trims the harvested tissue to the same size as the defect.
7. The graft is then secured underneath the conjunctiva using sutures or tissue adhesive.
8. After the procedure, a pressure patch with antibiotic ointment is applied.

4. Qualifying circumstances

CPT 68320 is typically performed on patients with conditions such as conjunctivochalasis, where there are excess folds of conjunctiva in the eye. The procedure is done by a qualified healthcare professional under local anesthesia. The patient’s own conjunctival tissue is used as a graft or the existing tissue is rearranged to repair the conjunctiva.

5. When to use CPT code 68320

CPT code 68320 should be used when a surgical repair of the conjunctiva is performed using the patient’s own conjunctival tissue as a graft or by rearranging the existing tissue. This code is appropriate for cases where there is a need for extensive repair or grafting of the conjunctiva.

6. Documentation requirements

To support a claim for CPT 68320, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for conjunctival repair
• Details of the procedure performed, including whether a graft or rearrangement of tissue was used
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 68320, ensure that the procedure meets the criteria for conjunctival repair using a graft or extensive rearrangement. It is important to use the appropriate CPT code based on the specific procedure performed. Modifier E1 should be used for upper left eyelid, E2 for lower left eyelid, E3 for upper right eyelid, and E4 for lower right eyelid. These modifiers provide additional clinical information to the payer.

8. Historical information

CPT 68320 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 conjunctivoplasty with conjunctival graft to repair conjunctivochalasis.
2. A healthcare professional performs conjunctivoplasty with extensive rearrangement of conjunctival tissue to correct a conjunctival defect.
3. A patient with excess folds of conjunctiva in the eye undergoes conjunctivoplasty with conjunctival graft for cosmetic purposes.
4. A conjunctivoplasty procedure is performed using the patient’s own conjunctival tissue as a graft to repair a conjunctival laceration.
5. A healthcare professional performs conjunctivoplasty with extensive rearrangement of conjunctival tissue to treat a recurrent conjunctival cyst.
6. A patient undergoes conjunctivoplasty with conjunctival graft to repair a conjunctival lesion.
7. A healthcare professional performs conjunctivoplasty with extensive rearrangement of conjunctival tissue to correct conjunctival scarring.
8. A patient with conjunctivochalasis undergoes conjunctivoplasty with conjunctival graft to alleviate symptoms.
9. A healthcare professional performs conjunctivoplasty with extensive rearrangement of conjunctival tissue to repair a conjunctival defect caused by trauma.
10. A patient undergoes conjunctivoplasty with conjunctival graft to correct a conjunctival malformation.