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Official Description

Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Entropion is a medical condition characterized by the inward rotation of the eyelid margin towards the eye's surface. This abnormal positioning causes the eyelashes and the eyelid itself to come into contact with the conjunctiva and cornea, leading to irritation. 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 patients, often due to age-related changes in the eyelid's structure and function. The repair of entropion, specifically extensive cases, involves surgical procedures designed to correct the eyelid's position and restore its normal function. The surgical approach may include techniques such as the tarsal strip procedure or capsulopalpebral fascia repair, depending on the specific characteristics and severity of the entropion. Prior to the procedure, local anesthesia is typically administered to ensure patient comfort, and a corneal shield is placed to protect the eye during surgery. The choice of surgical technique is determined by the individual patient's needs and the complexity of the entropion being addressed.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Entropion repair is indicated for patients presenting with the following conditions:

  • Inward rotation of the eyelid margin - This condition leads to the eyelashes rubbing against the conjunctiva and cornea, causing irritation.
  • Corneal abrasion - Damage to the cornea resulting from the constant friction of the eyelashes against its surface.
  • Corneal ulceration - A more severe complication that can arise from untreated entropion, leading to potential vision loss.
  • Age-related changes - Commonly seen in elderly individuals, where structural changes in the eyelid contribute to the development of entropion.

2. Procedure

The procedure for repairing entropion involves several detailed steps to ensure effective correction of the eyelid's position:

  • Local Anesthesia Administration - A local anesthetic is injected into the eyelid to minimize discomfort during the procedure. This may be supplemented with a nerve block as needed for additional pain control.
  • Placement of Corneal Shield - A corneal shield is positioned to protect the eye from any surgical instruments and to prevent injury during the procedure.
  • Incision and Mobilization - For a lateral tarsal strip procedure, an incision is made at the lateral canthus, allowing for the mobilization of the lower eyelid. If there is excess skin, it is excised to facilitate proper eyelid positioning.
  • Trimming of Meibomian Orifices - The lid margin is split, and the meibomian orifices of the lateral strip are trimmed to ensure proper healing and function.
  • Inspection of Lateral Conjunctiva - The lateral conjunctiva is inspected and scraped to prevent the formation of epithelial inclusion cysts, which can occur postoperatively.
  • Suturing of Tarsal Strip - The lateral strip of tarsus is sutured to the periosteum of the lateral orbital rim, specifically near Whitnall's tubercle, to secure the eyelid in its corrected position.
  • Closure of Surgical Wound - The surgical wound is closed in layers to ensure proper healing and minimize scarring.
  • Canthal Tightening (if necessary) - If the entropion is due to horizontal and vertical laxity of the eyelid, additional procedures such as medial and/or lateral canthal tightening may be performed. This involves using a tarsal strip procedure followed by vertical shortening and reattachment of the lower eyelid retractors to the inferior border of the tarsus.

3. Post-Procedure

After the entropion repair procedure, patients can expect a recovery period that may involve some swelling and discomfort. Post-operative care typically includes the use of prescribed eye drops to prevent infection and promote healing. Patients are advised to avoid rubbing their eyes and to follow up with their healthcare provider for monitoring the surgical site and ensuring proper eyelid function. The expected recovery time may vary based on the individual’s overall health and the complexity of the procedure performed.

Short Descr REPAIR EYELID DEFECT
Medium Descr REPAIR ENTROPION EXTENSIVE
Long Descr Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)
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 2
CCS Clinical Classification 19 - Other therapeutic procedures on eyelids, conjunctiva, cornea
E4 Lower right, eyelid
RT Right side (used to identify procedures performed on the right side of the body)
E2 Lower left, eyelid
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).
SG Ambulatory surgical center (asc) facility service
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).
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.)
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.
E1 Upper left, eyelid
E3 Upper right, eyelid
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.
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.
73 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure prior to the administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may cancel a surgical or diagnostic procedure subsequent to the patient's surgical preparation (including sedation when provided, and being taken to the room where the procedure is to be performed), but prior to the administration of anesthesia (local, regional block(s) or general). under these circumstances, the intended service that is prepared for but cancelled can be reported by its usual procedure number and the addition of modifier 73. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
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.)
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
ET Emergency services
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
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
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
Date
Action
Notes
2004-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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