CPT® Code 67515

The procedure described by CPT® Code 67515 involves the injection of medication or other substances directly into Tenon's capsule, a specialized anatomical structure surrounding the eyeball. Tenon's capsule is a thin, fascial sheath that serves to envelop the eyeball, providing a protective layer that separates the eye from the surrounding orbital fat. This sheath has a smooth and shiny inner surface, which is separated from the outer surface of the sclera by a potential space known as the episcleral or sub-Tenon's space. The attachment of the fascial sheath to the sclera is facilitated by fine bands of connective tissue, ensuring stability and support for the eye. The anterior aspect of Tenon's capsule is anchored to the sclera approximately 1.5 cm behind the corneoscleral junction, while the posterior aspect fuses with the meninges surrounding the optic nerve, as well as with the sclera at the point where the optic nerve exits the eyeball. Additionally, the tendons of the six extrinsic eye muscles penetrate through this sheath, which forms a tubular sleeve around these tendons, allowing for the necessary movement of the eye. In the context of the injection procedure, local anesthetic eye drops are first administered to minimize discomfort. An eyelid speculum is then utilized to keep the eyelids open during the procedure. The patient is instructed to look upwards and outwards, which facilitates access to the Tenon's capsule and sclera. A forceps may be used to grasp these structures, and a small incision may be made to aid in the insertion of a blunt, curved sub-Tenon's capsule cannula. This cannula is carefully mounted on a syringe and inserted along the curvature of the sclera, advancing into the posterior sub-Tenon's space. Once in position, the medication or other substance is injected, and after the cannula is removed, pressure is applied over the globe to ensure that the injected substance disperses throughout the capsule effectively.