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The procedure described by CPT® Code 65272 involves the repair of a laceration to the conjunctiva, which is the thin, transparent mucous membrane that covers the sclera, or the white part of the eye, as well as the inner surface of the eyelids. This procedure is performed under local anesthesia to ensure patient comfort. Prior to the repair, a thorough examination of the eye is conducted to confirm that there is no damage to the globe, which is the eyeball itself. If necessary, the edges of the laceration are debrided to prepare them for proper healing. The conjunctiva is then mobilized and rearranged to alleviate any tension on the laceration edges, which is crucial for optimal healing. In some cases, a flap may be created to provide sufficient coverage over the defect. The final step involves the use of absorbable sutures to secure the conjunctiva in place, facilitating the healing process. It is important to note that this code is applicable when the injury does not necessitate hospitalization, distinguishing it from CPT® Code 65273, which is used when hospitalization is required for the procedure.
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The procedure is indicated for the repair of lacerations to the conjunctiva, which may occur due to trauma, injury, or surgical complications. The following conditions may warrant the performance of this procedure:
The procedure for repairing a conjunctival laceration involves several critical steps to ensure effective treatment and recovery. First, local anesthetic is administered to the patient to minimize discomfort during the procedure. Following anesthesia, a comprehensive examination of the eye is conducted to confirm that the globe is intact and free from injury. This step is essential to avoid further complications during the repair process. Once the examination is complete, the edges of the laceration are carefully debrided as needed. This debridement process involves removing any non-viable tissue or debris from the laceration edges to promote optimal healing. After debridement, the conjunctiva is mobilized and rearranged. This step is crucial as it relieves tension on the edges of the laceration, which can hinder proper healing. In some cases, a flap may be developed to ensure adequate coverage of the defect created by the laceration. Finally, the defect is repaired using absorbable sutures, which secure the conjunctiva in place and facilitate healing without the need for suture removal. This entire procedure is performed on an outpatient basis, meaning that hospitalization is not required.
After the conjunctival laceration repair, patients are typically monitored for any immediate complications. Post-procedure care may include instructions on how to care for the eye, such as avoiding rubbing or touching the area, and the use of prescribed eye drops or ointments to prevent infection and promote healing. Patients are advised to follow up with their healthcare provider to ensure proper recovery and to address any concerns that may arise during the healing process. It is important for patients to report any signs of complications, such as increased pain, redness, or discharge from the eye, as these may indicate the need for further evaluation or treatment.
| Short Descr | REPAIR OF EYE WOUND | Medium Descr | RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION | Long Descr | Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization | 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 | 1 | CCS Clinical Classification | 19 - Other therapeutic procedures on eyelids, conjunctiva, cornea |
| 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). | 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.) | 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) |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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