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The procedure described by CPT® Code 68705 involves the correction of an everted punctum through the use of cautery. The inferior punctum, which is a small opening located at the inner corner of the lower eyelid, is typically oriented in a way that it faces the back of the eye, allowing for proper drainage of tears. However, in cases where the punctum is everted, it turns outward and away from the eye, which can lead to issues with tear drainage and potential discomfort. To address this condition, a probe is inserted through the everted punctum and into the canaliculus, which is the channel that carries tears from the punctum to the nasolacrimal duct. During the procedure, the lower eyelid is everted, and specific areas are cauterized. This cauterization creates a controlled burn that, upon healing, results in scar tissue formation. The scar tissue will contract over time, effectively pulling the everted punctum back into a more anatomically correct position, ensuring it is once again in contact with the globe of the eye. This procedure is essential for restoring normal tear drainage and alleviating any associated symptoms caused by the everted punctum.
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The procedure described by CPT® Code 68705 is indicated for patients presenting with an everted punctum, which can lead to inadequate tear drainage and associated symptoms. The following conditions may warrant this corrective procedure:
The procedure for correcting an everted punctum using cautery involves several key steps, each critical to achieving the desired outcome. The following outlines the procedural steps:
Following the procedure, patients may be advised on specific post-operative care to ensure optimal healing and recovery. This may include instructions to avoid rubbing the eyes, using prescribed eye drops to manage any discomfort, and attending follow-up appointments to monitor the healing process. Patients should be informed about the expected timeline for recovery, which typically involves a gradual improvement in symptoms as the scar tissue forms and the punctum returns to its proper position. Any signs of complications, such as increased redness, swelling, or discharge, should be reported to the healthcare provider promptly for further evaluation.
| Short Descr | REVISE TEAR DUCT OPENING | Medium Descr | CORRECTION EVERTED PUNCTUM CAUTERY | Long Descr | Correction of everted punctum, cautery | Status Code | Active Code | Global Days | 010 - Minor Procedure | 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 | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight. | 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 |
| 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). | 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.) | 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. | 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 | 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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