How To Use CPT Code 68745

CPT 68745 describes a surgical procedure known as conjunctivorhinostomy, which involves creating a passageway between the conjunctiva and the nasal cavity. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 68745?

CPT 68745 is a code used to describe a surgical procedure called conjunctivorhinostomy. This procedure involves creating a tract or passageway between the conjunctiva, the transparent membrane that covers the eye, and the nasal cavity. It is performed to treat excessive tearing caused by the blockage of tear ducts by a fleshy growth in the corner of the eye.

2. Official Description

The official description of CPT code 68745 is: ‘Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube.’

3. Procedure

1. The provider begins by making an incision in the skin in the medial canthal area, extending it to the orbital rim.
2. Next, the provider exposes the bone below the medial canthus and along the orbital rim.
3. A hole is drilled into the nasal bone.
4. The provider then elevates flaps from the conjunctival mucosa and sutures them to the mucosa of the nose, creating a tract between the conjunctiva and the nasal cavity.
5. No tube is left in the tract.
6. The provider checks for bleeding, removes any instruments, and observes the patient for a short period before releasing them.

4. Qualifying circumstances

CPT 68745 is performed on patients who have complete blockage of the punctum and canaliculi, resulting in excessive tearing. The procedure is intended to alleviate this condition by creating a passageway between the conjunctiva and the nasal cavity. It is important to note that this procedure does not involve the insertion of a tube or stent.

5. When to use CPT code 68745

CPT code 68745 should be used when the provider performs a conjunctivorhinostomy without the insertion of a tube or stent. If a tube or stent is inserted during the procedure, CPT code 68750 should be used instead.

6. Documentation requirements

To support a claim for CPT 68745, the provider must document the following information:

• Patient’s diagnosis and the need for conjunctivorhinostomy
• Details of the procedure, including the incision, drilling, and suturing
• Confirmation that no tube or stent was inserted
• Date of the procedure
• Any complications or additional observations
• Provider’s signature

7. Billing guidelines

When billing for CPT 68745, ensure that the procedure performed does not involve the insertion of a tube or stent. If a tube or stent is inserted, CPT code 68750 should be used instead. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 68745 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. A patient undergoes conjunctivorhinostomy to treat excessive tearing caused by a blockage in the tear ducts.
2. A provider performs conjunctivorhinostomy on a patient with a fleshy growth in the corner of their eye, resulting in excessive tearing.
3. A conjunctivorhinostomy is performed on a patient who has been experiencing chronic tearing due to a blockage in the tear ducts.
4. A provider performs conjunctivorhinostomy on a patient with a history of tear duct blockage, resulting in excessive tearing.
5. A patient undergoes conjunctivorhinostomy to alleviate the symptoms of excessive tearing caused by a blockage in the tear ducts.
6. A provider performs conjunctivorhinostomy on a patient with persistent tearing due to a blockage in the tear ducts.
7. A conjunctivorhinostomy is performed on a patient with a fleshy growth in the corner of their eye, resulting in chronic tearing.
8. A provider performs conjunctivorhinostomy on a patient with a history of tear duct blockage, resulting in persistent tearing.
9. A patient undergoes conjunctivorhinostomy to alleviate the symptoms of chronic tearing caused by a blockage in the tear ducts.
10. A provider performs conjunctivorhinostomy on a patient with persistent tearing due to a blockage in the tear ducts.