How To Use CPT Code 68500

CPT 68500 describes the excision of the lacrimal gland, except for tumor, to treat excessive tearing and dry 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 68500?

CPT 68500 involves the removal of the lacrimal gland, except for tumor, to address excessive tearing and dry eye. This procedure is performed to alleviate the symptoms caused by an overactive lacrimal gland.

2. Official Description

The official description of CPT code 68500 is: ‘Excision of lacrimal gland (dacryoadenectomy), except for tumor; total.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made to expose the lacrimal gland.
3. The provider carefully separates the gland from its attachments.
4. The entire lacrimal gland is removed.
5. The wound is closed in layers.
6. The patient is observed for a brief period and then released.

4. Qualifying circumstances

CPT 68500 is performed when a patient experiences excessive tearing and dry eye due to an overactive lacrimal gland. This procedure is not performed for tumors. It is important to note that partial excision of the lacrimal gland should be reported with a different code, such as 68505.

5. When to use CPT code 68500

CPT code 68500 should be used when the provider performs a total excision of the lacrimal gland, except for tumor, to address excessive tearing and dry eye. It is important to accurately document the procedure and ensure that it meets the criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 68500, the provider must document the following information:

• Patient’s symptoms and the need for lacrimal gland excision
• Details of the procedure, including the incision, separation of the gland, and removal
• Documentation of any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 68500, ensure that the excision is performed as described in the code. It is important to accurately document the procedure and meet the criteria outlined in the code description. CPT code 68500 should not be reported with codes 68505 or any other codes that describe partial excision of the lacrimal gland.

8. Historical information

CPT 68500 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 excessive tearing and dry eye. The provider performs a total excision of the lacrimal gland to alleviate the symptoms.
2. An individual experiences persistent tearing and discomfort. The provider determines that an excision of the lacrimal gland, except for tumor, is necessary to address the issue.
3. A patient complains of chronic dry eye. After evaluation, the provider decides to perform a total excision of the lacrimal gland to improve the patient’s condition.
4. An individual’s excessive tearing affects their daily life. The provider recommends a total excision of the lacrimal gland to alleviate the symptoms and improve the patient’s quality of life.
5. A patient’s dry eye symptoms worsen despite conservative treatments. The provider decides to perform a total excision of the lacrimal gland to provide relief.
6. Excessive tearing and discomfort persist in a patient. The provider determines that a total excision of the lacrimal gland is necessary to address the underlying cause of the symptoms.
7. A patient experiences chronic dry eye and seeks medical intervention. The provider performs a total excision of the lacrimal gland to alleviate the symptoms and improve the patient’s ocular health.
8. An individual’s excessive tearing affects their ability to wear contact lenses. The provider recommends a total excision of the lacrimal gland to address the issue and improve the patient’s comfort.
9. A patient’s persistent tearing causes social and functional limitations. The provider decides to perform a total excision of the lacrimal gland to alleviate the symptoms and improve the patient’s quality of life.
10. An individual’s dry eye symptoms significantly impact their daily activities. The provider determines that a total excision of the lacrimal gland is necessary to provide long-term relief.