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Entropion is a medical condition characterized by the inward rotation of the eyelid margin towards the surface of the eye. This abnormal positioning causes the eyelashes and the eyelid itself to come into contact with the conjunctiva and cornea, leading to irritation and discomfort. If left untreated, this irritation can escalate to more severe complications such as corneal abrasion and ulceration, which can significantly impact vision. Entropion is most frequently observed in the lower eyelid of elderly individuals, making it a common concern in geriatric ophthalmology. The procedure associated with CPT® Code 67922 involves thermocauterization, a technique that utilizes heat to treat the affected eyelid. Prior to the procedure, a local anesthetic is administered to ensure patient comfort. During the thermocauterization process, a corneal protector is placed over the eye to safeguard the cornea from thermal injury. The eyelid is then everted, allowing for precise application of electrocautery to the affected tissue. This method is designed to create controlled burns that will heal into scar tissue, ultimately retracting the eyelid back to its normal position against the globe of the eye. This procedure serves as a corrective measure for entropion, aiming to alleviate the symptoms and prevent further ocular complications.
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Entropion repair via thermocauterization is indicated for patients experiencing the following conditions:
The procedure for repairing entropion through thermocauterization involves several critical steps:
After the thermocauterization procedure, patients can expect a recovery period during which they may experience some swelling and discomfort. It is essential to monitor the healing process to ensure that the eyelid returns to its proper position and that no complications arise. Follow-up appointments may be scheduled to assess the healing and effectiveness of the procedure. Patients are typically advised to avoid rubbing their eyes and to follow any specific post-operative care instructions provided by their healthcare provider to promote optimal recovery.
| Short Descr | REPAIR EYELID DEFECT | Medium Descr | REPAIR ENTROPION THERMOCAUTERIZATION | Long Descr | Repair of entropion; thermocauterization | 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 | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 2 | 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). | 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). | 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) | 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. | 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.) | 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 |
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