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Official Description

Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Probing of the nasolacrimal duct (NLD) is a medical procedure aimed at addressing obstructions in the tear duct system, which can lead to excessive tearing or infections. The nasolacrimal duct is a small channel that allows tears to drain from the eye into the nasal cavity. In cases of congenital obstruction, which is often seen in infants, the duct fails to open properly into the nose, leading to potential complications. While many congenital obstructions resolve on their own by the age of 12 months, those that persist may require intervention. The procedure involves the insertion of a probe into the duct to locate and open the obstructed area. This may be accompanied by irrigation, where a saline solution is used to clear any debris or blockages. In adults, acquired obstructions can also occur, necessitating similar probing techniques. The procedure may be enhanced by transluminal balloon catheter dilation, where a balloon is inflated within the duct to widen it, thereby improving drainage. This comprehensive approach ensures that the nasolacrimal duct is adequately treated, promoting better eye health and comfort for the patient.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Probing of the nasolacrimal duct with or without irrigation, and with transluminal balloon catheter dilation, is indicated for the following conditions:

  • Congenital Nasolacrimal Duct Obstruction - This condition is characterized by the failure of the nasolacrimal duct to open into the nasal cavity, leading to excessive tearing and potential infections in infants.
  • Acquired Nasolacrimal Duct Obstruction - Adults may experience obstructions due to various factors, including age-related changes, trauma, or infections, necessitating intervention to restore normal tear drainage.

2. Procedure

The procedure for probing the nasolacrimal duct with or without irrigation, and with transluminal balloon catheter dilation, involves several key steps:

  • Step 1: Preparation - The patient is positioned comfortably, and the area around the eye is cleaned to minimize the risk of infection. Anesthesia may be administered if required, particularly in cases where the procedure is performed under general anesthesia.
  • Step 2: Probing - A probe is carefully inserted into the puncta, the small openings in the eyelids, and advanced through the nasolacrimal duct. The goal is to reach the nasal cavity or to touch the probe with a second probe inserted through the nasal punctum, confirming the passage through the duct.
  • Step 3: Irrigation (if applicable) - If irrigation is indicated, a saline solution containing fluorescein dye may be introduced into the duct to flush out any debris, obstructions, or stones that may be present, ensuring the duct is clear.
  • Step 4: Balloon Catheter Dilation - Following probing and irrigation, a deflated balloon catheter is inserted into the nasolacrimal duct. The position of the catheter is confirmed, and the balloon is inflated to expand the duct for a duration of 90 seconds. This inflation helps to widen the duct and alleviate any strictures.
  • Step 5: Additional Inflation Cycles - After the initial inflation, the balloon is deflated and reinflated for an additional 60 seconds. The catheter is then retracted slightly higher in the duct, and two more inflation/deflation cycles are performed to ensure thorough dilation.
  • Step 6: Completion - Once the dilation is complete, the deflated balloon catheter is carefully removed from the duct, concluding the procedure.

3. Post-Procedure

After the procedure, patients may be monitored for any immediate complications or adverse reactions. It is common for patients to experience some mild discomfort or swelling around the eye, which typically resolves within a few days. Follow-up appointments may be scheduled to assess the success of the procedure and to determine if further interventions are necessary. Patients are advised to report any signs of infection, such as increased redness, swelling, or discharge from the eye, to their healthcare provider promptly.

Short Descr PROBE NL DUCT W/BALLOON
Medium Descr PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION
Long Descr Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation
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 Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P4E - Eye procedure - other
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.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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
Date
Action
Notes
2008-01-01 Added First appearance in code book in 2008.
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