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Correction of trichiasis, as described by CPT® Code 67835, involves a surgical procedure aimed at addressing an eyelid condition where the eyelashes grow inward towards the eye, causing irritation and potential damage to the ocular surface. This inward orientation of the lashes can lead to discomfort, chronic irritation, and even corneal abrasions if left untreated. The procedure is particularly indicated when a significant portion of the eyelid is affected, necessitating a more extensive surgical intervention than simple eyelash removal. In this procedure, an incision is made along the lid margin, and a free mucous membrane graft is utilized to repair the defect created by the incision. The graft, typically harvested from the lower lip or another suitable site, is carefully shaped and sutured into place to restore the integrity of the eyelid and redirect the lashes away from the eye. This approach not only alleviates the immediate symptoms associated with trichiasis but also aims to provide a long-term solution to prevent recurrence of the condition.
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The procedure described by CPT® Code 67835 is indicated for the treatment of trichiasis, which is characterized by the inward growth of eyelashes towards the globe of the eye. This condition can lead to various symptoms and complications, including:
The procedure for correcting trichiasis using CPT® Code 67835 involves several key steps, which are detailed as follows:
After the procedure, patients may require specific post-operative care to ensure proper healing and to monitor for any complications. This may include instructions on keeping the surgical site clean, avoiding any irritants, and using prescribed medications such as antibiotics or anti-inflammatory agents to prevent infection and reduce swelling. Follow-up appointments are typically scheduled to assess the healing process and to ensure that the graft is integrating well with the surrounding tissue. Patients should be advised to report any unusual symptoms, such as increased pain, redness, or discharge, as these may indicate complications that require further evaluation.
| Short Descr | REVISE EYELASHES | Medium Descr | CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF | Long Descr | Correction of trichiasis; incision of lid margin, with free mucous membrane graft | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P4E - Eye procedure - other | MUE | 1 | CCS Clinical Classification | 19 - Other therapeutic procedures on eyelids, conjunctiva, cornea |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | E1 | Upper left, eyelid | E2 | Lower left, eyelid | E3 | Upper right, eyelid | E4 | Lower right, eyelid | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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