How To Use CPT Code 68362

CPT code 68362 describes the creation of a conjunctival flap, which is used to cover another site on the eye. 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 68362?

CPT 68362 can be used to describe the creation of a conjunctival flap by a healthcare provider. This flap is made from free conjunctival tissue and is used to cover a recipient site on the eye, such as a diseased cornea. The procedure is performed under local anesthesia and involves the removal of a small piece of conjunctival tissue to create the flap. The flap is then secured to the recipient site with sutures.

2. Official Description

The official description of CPT code 68362 is: ‘Conjunctival flap; total (such as Gunderson thin flap or purse string flap).’ This code is used to report the creation of a conjunctival flap to cover a recipient site on the eye.

3. Procedure

1. The healthcare provider begins by placing an ocular speculum in the patient’s eye to keep it open during the procedure.
2. Using an operating microscope and microsurgical techniques, the provider prepares the recipient site on the eye.
3. The provider evaluates the most suitable site for obtaining a conjunctival segment and elevates the conjunctiva from the underlying tissue.
4. A small strip of conjunctiva is undermined to create a free flap.
5. The provider positions the flap on the recipient site, such as a diseased cornea, and secures it with sutures.
6. After the procedure, the provider applies an antibiotic ointment and patches the eye.

4. Qualifying circumstances

CPT 68362 is used when a healthcare provider creates a conjunctival flap to cover a recipient site on the eye. This procedure is typically performed to treat a nonhealing, progressive, or deep corneal ulceration. The patient must be under local anesthesia, and the provider must use microsurgical techniques to perform the procedure.

5. When to use CPT code 68362

CPT code 68362 should be used when a healthcare provider creates a conjunctival flap to cover a recipient site on the eye. This code is appropriate for reporting the procedure when performed under local anesthesia and using microsurgical techniques. It should not be used for other procedures on the conjunctiva that do not involve the creation of a flap.

6. Documentation requirements

To support a claim for CPT code 68362, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the conjunctival flap procedure
• Details of the procedure, including the use of microsurgical techniques
• Date of the procedure
• Start and end time of the procedure
• Description of the recipient site and the specific conjunctival flap used
• Details of any sutures used to secure the flap
• Application of antibiotic ointment and eye patch after the procedure

7. Billing guidelines

When billing for CPT code 68362, ensure that the procedure meets the qualifying circumstances described earlier. Use the appropriate CPT code for the specific conjunctival flap created. It is important to accurately document the details of the procedure to support the claim. Consider using the E modifiers for eyelid procedures, if applicable, to provide additional clinical information to the payer.

8. Historical information

CPT code 68362 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 creates a conjunctival flap to cover a nonhealing corneal ulceration in a patient’s left eye.
2. A patient undergoes a conjunctival flap procedure to treat a deep corneal ulceration in their right eye.
3. A healthcare provider performs a conjunctival flap surgery using microsurgical techniques to cover a progressive corneal ulceration in a patient’s left eye.
4. A conjunctival flap is created to cover a recipient site on the eye of a patient with a nonhealing corneal ulceration in their right eye.
5. A healthcare provider uses a conjunctival flap to treat a deep corneal ulceration in a patient’s left eye, ensuring proper coverage of the recipient site.
6. A patient undergoes a conjunctival flap procedure to address a progressive corneal ulceration in their right eye, with the flap securely sutured in place.
7. A healthcare provider performs a conjunctival flap surgery using microsurgical techniques to cover a nonhealing corneal ulceration in a patient’s left eye, achieving successful closure of the recipient site.
8. A conjunctival flap is created to treat a deep corneal ulceration in a patient’s right eye, with the flap carefully positioned and secured.
9. A healthcare provider uses a conjunctival flap to address a progressive corneal ulceration in a patient’s left eye, ensuring proper alignment and attachment of the flap.
10. A patient undergoes a conjunctival flap procedure to treat a nonhealing corneal ulceration in their right eye, with the flap providing effective coverage and protection.