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The procedure described by CPT® Code 68770 refers to the closure of a lacrimal fistula, which is classified as a separate procedure. A lacrimal fistula is an abnormal connection or passageway that forms between the lacrimal system and the skin, allowing tears or other fluids to drain externally. These fistulas can be either congenital, meaning they are present at birth, or acquired, which may occur due to trauma or disease processes such as infections. Congenital fistulas can be categorized into open and closed types. Open fistulous tracts are characterized by a visible small hole located inferior to the medial canthus, where tears or other fluids can leak onto the skin. In contrast, closed fistulous tracts terminate in a blind sac and do not exhibit any drainage. The closure of a lacrimal fistula typically involves the administration of a local anesthetic to ensure patient comfort during the procedure. Following anesthesia, the fistulous tract is carefully inspected, and the closure is achieved through techniques such as electrocautery or laser surgery, among other methods. This procedure aims to restore normal drainage of tears and prevent any further complications associated with the fistula.
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The closure of a lacrimal fistula, as indicated by CPT® Code 68770, is performed for specific conditions related to the presence of a lacrimal fistula. The following are the indications for this procedure:
The procedure for the closure of a lacrimal fistula involves several key steps, which are outlined as follows:
After the closure of the lacrimal fistula, patients may require specific post-procedure care to ensure proper healing and recovery. This may include monitoring for any signs of infection, managing discomfort, and following up with the healthcare provider to assess the success of the procedure. Patients are typically advised on any restrictions regarding activities and may be given instructions on how to care for the surgical site to promote optimal healing.
| Short Descr | CLOSE TEAR SYSTEM FISTULA | Medium Descr | CLOSURE LACRIMAL FISTULA SPX | Long Descr | Closure of lacrimal fistula (separate procedure) | 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) | 0 - 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) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | 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). | 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. | 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.) | E2 | Lower left, 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 | 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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