How To Use CPT Code 68811

CPT 68811 describes the procedure of probing the nasolacrimal duct, with or without irrigation, and it may require general anesthesia. 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 68811?

CPT 68811 can be used to describe the probing of the nasolacrimal duct, with or without irrigation, which may require general anesthesia. This code is used when a healthcare provider performs a procedure to identify possible obstructions or strictures in the nasolacrimal duct.

2. Official Description

The official description of CPT code 68811 is: ‘Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia.’ This code may also require the use of modifier 50 for a bilateral procedure.

3. Procedure

1. With the patient under general anesthesia, the healthcare provider dilates the lacrimal drainage system.
2. They insert a punctual dilator medially and dilate the punctum, resulting in the widening of the punctum.
3. A probe is then inserted into the inferior or superior punctum and passed through until a hard stop is reached.
4. The healthcare provider may choose to irrigate the canaliculus with fluorescein-stained saline and perform further irrigation if necessary.
5. Finally, the cannula is removed, and antibiotics are instilled.

4. Qualifying circumstances

CPT 68811 is performed on patients who require general anesthesia for the probing of the nasolacrimal duct. It is used to identify possible obstructions or strictures in the tear ducts. The procedure may be necessary for patients experiencing issues with tear drainage.

5. When to use CPT code 68811

CPT code 68811 should be used when a healthcare provider performs the probing of the nasolacrimal duct, with or without irrigation, and the procedure requires general anesthesia. It is important to ensure that the specific circumstances of the procedure align with the code description.

6. Documentation requirements

To support a claim for CPT 68811, the healthcare provider must document the following information:

• Patient’s medical history and the need for the procedure
• Details of the procedure performed, including the use of general anesthesia
• Date and duration of the procedure
• Any complications or additional steps taken during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 68811, ensure that the procedure was performed with general anesthesia. If the procedure is performed on both eyes, use modifier 50 to indicate a bilateral procedure. Some payers may prefer the use of modifiers LT and RT instead of modifier 50. It is important to follow payer-specific guidelines for reporting bilateral procedures. Do not report CPT 68811 if the procedure was performed under local topical anesthesia. Be cautious not to confuse CPT 68811 with similar codes such as 68801 for dilation of the lacrimal punctum or 68840 for probing of lacrimal canaliculi.

8. Historical information

CPT 68811 was added to the Current Procedural Terminology system on January 1, 1997. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs probing of the nasolacrimal duct, with irrigation, under general anesthesia for a patient with chronic tear drainage issues.
2. During a surgical procedure, a specialist probes the nasolacrimal duct, without irrigation, using general anesthesia to identify and address an obstruction.
3. A patient with recurrent infections undergoes probing of the nasolacrimal duct, with irrigation, under general anesthesia to determine the cause of the infections.
4. A healthcare provider performs probing of the nasolacrimal duct, without irrigation, using general anesthesia for a patient experiencing excessive tearing.
5. During a routine eye examination, a specialist probes the nasolacrimal duct, with irrigation, under general anesthesia to assess tear drainage functionality.
6. A patient with a history of tear duct blockage undergoes probing of the nasolacrimal duct, without irrigation, using general anesthesia to alleviate the blockage.
7. A healthcare provider performs probing of the nasolacrimal duct, with irrigation, under general anesthesia for a patient with persistent watery eyes.
8. During a corrective eye surgery, a specialist probes the nasolacrimal duct, without irrigation, using general anesthesia to ensure proper tear drainage.
9. A patient with a congenital tear duct abnormality undergoes probing of the nasolacrimal duct, with irrigation, under general anesthesia to improve tear drainage.
10. A healthcare provider performs probing of the nasolacrimal duct, without irrigation, using general anesthesia for a patient with recurrent eye infections.