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The procedure described by CPT® Code 67935 pertains to the surgical repair of a recent wound on the eyelid that involves the lid margin, tarsus, and/or palpebral conjunctiva through direct closure, specifically a full-thickness closure. The eyelid is a complex structure composed of several layers, including the skin, orbicularis muscle, tarsus, and conjunctiva. When a wound penetrates beyond the skin layer, a layered closure technique is necessary to ensure proper healing and functional restoration of the eyelid. This procedure typically begins with the administration of anesthetic eye drops or other topical anesthetics to minimize discomfort during the repair. A corneal protector is then placed over the eye to safeguard the cornea during the procedure. The wound area is meticulously cleansed to remove any debris, and any damaged tissue is debrided to promote optimal healing. The repair process involves realigning the lid margin using a series of sutures, with specific techniques employed depending on the extent of the injury. If the wound involves the lid margin, mattress sutures may be utilized for effective closure. The procedure also includes suturing through the tarsus if it is affected, ensuring that the knotted ends of the sutures are directed away from the cornea to prevent irritation. Finally, if the palpebral conjunctiva is involved, it is repaired with sutures before closing the skin layer. It is important to note that CPT® Code 67930 should be used for partial-thickness injuries that do not extend through the entire eyelid, while CPT® Code 67935 is specifically designated for full-thickness wounds.
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The procedure associated with CPT® Code 67935 is indicated for the repair of recent full-thickness wounds of the eyelid that involve the lid margin, tarsus, and/or palpebral conjunctiva. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 67935 involves several critical steps to ensure effective repair of the eyelid wound:
Post-procedure care for patients undergoing the repair of a full-thickness eyelid wound includes monitoring for any signs of infection, ensuring proper wound healing, and managing any discomfort. Patients may be advised to avoid rubbing or putting pressure on the eye and to follow specific instructions regarding the use of topical medications or ointments. Follow-up appointments are typically scheduled to assess the healing process and to remove sutures if necessary. It is essential to educate patients on the importance of adhering to post-operative care instructions to promote optimal recovery and prevent complications.
| Short Descr | REPAIR EYELID WOUND | Medium Descr | SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK | Long Descr | Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness | 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 |
| 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. | 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. | 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.) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | 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) | 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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| Pre-1990 | Added | Code added. |
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