2025 CPT code 68840
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Probing of lacrimal canaliculi, with or without irrigation.
Modifiers –50 (bilateral procedure), –RT (right side), and –LT (left side) may be applicable.
Medical necessity is established by symptoms consistent with lacrimal system obstruction (such as epiphora, recurrent infections, or congenital obstruction).The procedure is medically necessary to assess and treat the obstruction, improving drainage and potentially resolving symptoms.
After administering local anesthesia, the physician inserts a probe into the lacrimal canaliculi and probes. Irrigation may be performed if deemed necessary by the physician.
In simple words: The doctor checks the tear ducts using a small probe, and may also flush them with a fluid to clear any blockages.
This procedure involves probing the lacrimal canaliculi to assess patency and, if necessary, irrigating the canaliculi to remove obstructions.Local anesthesia is administered before a probe is inserted into the canaliculi. Irrigation may be performed depending on the physician's assessment.
Example 1: A patient presents with epiphora (excessive tearing) and a suspected blockage in the lacrimal canaliculi. The physician performs probing and irrigation to assess and address the blockage., A patient experiences recurrent infections of the lacrimal system.The physician utilizes probing and irrigation to ascertain the extent of any obstruction that may be contributing to these infections., A newborn presents with congenital nasolacrimal duct obstruction.The physician performs probing to establish drainage from the lacrimal system.
* Detailed history and physical examination documenting the indication for the procedure (e.g., epiphora, recurrent infections, congenital obstruction).* Documentation of the procedure performed, including whether irrigation was performed and the findings (e.g., patency, presence of obstruction, type of obstruction).* Post-operative notes documenting the patient's response to the procedure.
** The payment for 68840 is allowed per eye, not per lid.If bilateral probing is performed, appropriate modifiers should be used to indicate this. Carriers may reduce coverage to a unilateral payment if the indications for a bilateral procedure are not clearly documented.
- Revenue Code: P6C
- RVU: This information is not available in the provided source.Refer to the CMS National Physician Fee Schedule for current RVU values.
- Global Days: This information is not available in the provided source.Global surgical days vary depending on the payer and specific circumstances.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: This information is not available in the provided source. Refer to historical fee schedules from Medicare or other payers for this information.
- Specialties:Ophthalmology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgery Center