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The procedure described by CPT® Code 65290 involves the repair of a wound affecting the extraocular muscle, tendon, and/or Tenon's capsule. This surgical intervention is performed using conventional sutures to restore the integrity of the affected structures. The eye is meticulously examined, often utilizing a slit lamp or operating microscope, to assess the extent of the wound and any potential damage to surrounding ocular structures. The eyeball is supported within the orbit and is encased by Tenon's capsule, a fibrous tissue that extends from the optic nerve entrance to the corneal limbus, firmly attaching to the conjunctiva. The extraocular muscles, which include the horizontal rectus, vertical rectus, and oblique muscles, are connected to the sclera (the white part of the eye) via broad, thin tendons. A wound on the cornea or sclera can compromise the structural integrity of these muscles, tendons, and Tenon's capsule. During the procedure, the surgeon identifies the ends of any transected muscle or tendon, reapproximates them, and secures them with sutures. Additionally, Tenon's capsule is carefully dissected to remove any foreign bodies or trapped tissue, which is then closed with sutures. At the conclusion of the surgery, antibiotics may be administered directly into the conjunctiva or other areas of the eye, and the eye is protected with a sterile dressing and an eye shield to promote healing and prevent infection.
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The repair of a wound to the extraocular muscle, tendon, and/or Tenon's capsule is indicated in the following situations:
The procedure for repairing a wound to the extraocular muscle, tendon, and/or Tenon's capsule involves several critical steps:
Post-procedure care involves monitoring the patient for any signs of complications, such as infection or improper healing. The patient may be advised to keep the eye covered with a sterile dressing and eye shield for a specified period to protect the surgical site. Follow-up appointments are essential to assess healing and ensure that the extraocular muscles are functioning properly. Patients may also receive instructions regarding the use of prescribed medications, including antibiotics or anti-inflammatory agents, to support recovery and manage any discomfort.
| Short Descr | REPAIR OF EYE SOCKET WOUND | Medium Descr | RPR WND EXTRAOCULAR MUSCLE TENDON&/TENON CAPSU | Long Descr | Repair of wound, extraocular muscle, tendon and/or Tenon's capsule | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | 21 - Other extraocular muscle and orbit therapeutic procedures |
| 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. | 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.) | E2 | Lower left, eyelid | E3 | Upper 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 |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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