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The procedure described by CPT® Code 67882 involves the construction of intermarginal adhesions through median tarsorrhaphy or canthorrhaphy, combined with the transposition of the tarsal plate. The eyelids are composed of several layers of tissue, including the skin, orbicularis muscle, tarsus, and conjunctiva. The tarsal plates, or tarsi, are made of dense fibrous tissue that provides structural integrity and shape to the upper and lower eyelids. The upper eyelid typically has a crescent shape, while the lower eyelid is more rectangular. Median tarsorrhaphy is a surgical technique that creates adhesions between the upper and lower eyelid margins at the midline, primarily to protect the cornea from exposure and potential damage. Canthorrhaphy, on the other hand, involves creating adhesions at the medial and lateral canthus, which are the corners of the eye. During median tarsorrhaphy, a narrow strip of skin is excised from both the upper and lower eyelids at the midline, with incisions made just behind the eyelashes. The resulting wounds are then approximated and secured with interrupted sutures. Canthorrhaphy follows a similar approach, with skin excised from the corners of the eyelids and the wounds sutured together. In the case of CPT® Code 67882, the procedure is enhanced by the transposition of the tarsal plate, which involves exposing and repositioning the tarsal plate to facilitate improved eyelid closure, thereby enhancing the overall effectiveness of the surgical intervention.
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The procedure described by CPT® Code 67882 is indicated for specific conditions that necessitate the construction of intermarginal adhesions to enhance eyelid function and protect the ocular surface. The following are the primary indications for this procedure:
The procedure associated with CPT® Code 67882 involves several key steps that are essential for achieving the desired surgical outcome. The following outlines the procedural steps:
Post-procedure care following the construction of intermarginal adhesions with transposition of the tarsal plate is essential for optimal recovery. Patients are typically advised to follow specific care instructions, which may include keeping the surgical area clean and dry, applying prescribed topical medications to prevent infection, and avoiding activities that could strain the eyelids. Follow-up appointments are crucial to monitor healing and assess the effectiveness of the procedure. Patients may experience some swelling and discomfort initially, which is expected and can be managed with prescribed pain relief. It is important for patients to adhere to the post-operative guidelines provided by their healthcare provider to ensure proper healing and minimize complications.
| Short Descr | REVISION OF EYELID | Medium Descr | CONSTJ INTERMARGIN ADHES/TARSOR/CANTHOR W/TRPOS | Long Descr | Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate | 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 |
| LT | Left side (used to identify procedures performed on the left side of the body) | 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) | 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. | 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). | 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. | 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.) | CR | Catastrophe/disaster related | 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 | SG | Ambulatory surgical center (asc) facility service | 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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