2025 CPT code 65270
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Repair of a laceration of the conjunctiva, with or without a nonperforating laceration of the sclera, using direct closure.
Modifiers may be applicable to this code. Modifier 50 is used for bilateral procedures. Modifiers 22, 52, and 73-79 can be used to indicate increased procedural services, reduced services, or discontinued procedures.
Medical necessity for this procedure is established by the presence of a conjunctival laceration that requires surgical repair to prevent complications such as infection, scarring, or vision impairment. A nonperforating scleral laceration adds to the complexity and medical necessity. The documentation must clearly support the need for the repair.
The physician preps and anesthetizes the patient, repositions any torn edges of the conjunctiva using forceps or a cotton-tipped applicator, closes the laceration with absorbable sutures, and applies antibiotics and a pressure patch.
In simple words: This procedure fixes a cut in the clear part covering your eye and, if needed, the white part of your eye, by stitching the edges of the cut together.
This procedure involves repairing a tear (laceration) in the conjunctiva (the clear membrane covering the eye) and, if present, a nonperforating laceration in the sclera (the white of the eye). The repair is performed by bringing the edges of the wound together and closing it with sutures (direct closure).
Example 1: A patient presents to the ER with a conjunctival laceration after being poked in the eye with a tree branch. The laceration is less than 1 cm and doesn't involve the sclera. The physician repairs the laceration with 65270., A patient sustains a nonperforating scleral laceration and an associated conjunctival laceration during a car accident, requiring repair under anesthesia using absorbable sutures (65270)., A child playing with scissors accidentally cuts their eyelid, resulting in a conjunctival laceration and a small, nonperforating scleral laceration. The ophthalmologist performs a direct closure repair, using 65270.
Documentation should include the location, size, and depth of the laceration(s), the method of repair, the type of suture material used, and any complications encountered. The medical record must support the medical necessity of the repair, the complexity of the injury, and whether it involved the sclera.
** Conjunctival lacerations smaller than 1 cm may not require sutures and may heal on their own with antibiotic ointment. This code does not include the removal of a foreign body, which can be reported separately with code 65210 if performed.
- Revenue Code: P4E - EYE PROCEDURE - OTHER
- Specialties:Ophthalmology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Emergency Room - Hospital