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The procedure described by CPT® Code 67880 involves the construction of intermarginal adhesions through median tarsorrhaphy or canthorrhaphy. The eyelids are complex structures composed of several layers, including the skin, orbicularis muscle, tarsus, and conjunctiva. The tarsal plates, or tarsi, are made of dense fibrous tissue that provides the eyelids with their distinct shapes; the upper eyelid is crescent-shaped, while the lower eyelid is rectangular. Median tarsorrhaphy is a surgical technique that creates adhesions between the upper and lower eyelid margins at the midline, primarily aimed at protecting the cornea from exposure or injury. In contrast, canthorrhaphy involves forming adhesions at the corners of the eyelids, known as the medial and lateral canthus. The procedure begins with the excision of a narrow strip of skin from both the upper and lower eyelids at the midline, with incisions made just posterior to the eyelashes. The resulting surgical wounds are then approximated and secured using interrupted sutures to ensure proper healing and alignment. Canthorrhaphy follows a similar approach, where skin is removed from the upper and lower eyelids at either the medial or lateral canthus, and the wounds are also approximated and sutured. This surgical intervention is crucial for maintaining eyelid function and protecting the ocular surface.
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The procedure described by CPT® Code 67880 is indicated for various conditions that necessitate the protection of the cornea and the maintenance of eyelid function. The following are specific indications for performing median tarsorrhaphy or canthorrhaphy:
The procedure for CPT® Code 67880 involves several key steps that are essential for achieving the desired outcome. The following outlines the procedural steps involved:
After the completion of the median tarsorrhaphy or canthorrhaphy procedure, patients are typically monitored for any immediate complications. Post-procedure care may include the application of antibiotic ointment to prevent infection and instructions on eyelid care. Patients are advised to avoid rubbing or putting pressure on the eyelids during the initial healing phase. Follow-up appointments are essential to assess the healing process and to remove sutures if necessary. Patients may experience some swelling and discomfort, which can be managed with prescribed pain relief medications. It is important for patients to adhere to the post-operative care instructions to ensure optimal recovery and to protect the cornea effectively.
| Short Descr | REVISION OF EYELID | Medium Descr | CONSTJ INTERMARGIN ADHES/TARSORRH/CANTHORRHAPY | Long Descr | Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; | 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) | 1 - Statutory 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 |
| 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). | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 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). | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 32 | Mandated services: services related to mandated consultation and/or related services (eg, third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure. | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number. | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | E1 | Upper left, eyelid | E2 | Lower left, eyelid | E3 | Upper right, eyelid | E4 | Lower right, eyelid | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure | SG | Ambulatory surgical center (asc) facility service | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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