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2025 CPT code 65273

Repair of a complex laceration of the conjunctiva requiring mobilization and rearrangement of tissues, performed in a hospital setting.

Do not report 65273 if the repair is simple and doesn't require hospitalization (use 65272). Ensure the documentation supports the complexity and the medical necessity for hospitalization.

Modifiers may be applicable to further specify the circumstances of the procedure.

Medical necessity is established by the complexity of the conjunctival laceration requiring mobilization and rearrangement, justifying the need for hospitalization for the procedure.

The ophthalmologist performs the procedure after prepping and anesthetizing the patient. This includes inspecting the injury, cleaning the tissue, rearranging and mobilizing the conjunctiva, and suturing the wound.

IMPORTANT:For repair without hospitalization, use 65272. For simple, intermediate, or complex linear repair of eyelid skin, see 12011-12018, 12051-12057, or 13151-13160 respectively. For lacrimal system repair, use 68700. For operative wound repair, use 66250. For diagnostic/treatment ophthalmological services, see codes 92002 et seq. Do not report 69990 in addition to 65091-68850.

In simple words: This procedure fixes a tear in the clear covering of your eye.Because the tear is complex and the edges don't line up easily, the doctor needs to rearrange the tissue before stitching it up. This procedure is complex enough that it requires a hospital stay.

This procedure involves the repair of a laceration of the conjunctiva, the membrane that covers the eye, using mobilization and rearrangement techniques. The complexity of the repair necessitates hospitalization.The surgeon cleanses the wound, rearranges the tissue, and uses sutures to close the laceration. This may involve making small incisions to properly mobilize the tissue for effective wound closure.

Example 1: A patient presents with a jagged laceration of the conjunctiva following a dog bite. Due to the irregular nature of the wound and the risk of infection, the repair requires hospitalization and complex rearrangement of the conjunctival tissue., A patient sustains a complex conjunctival laceration during a motor vehicle accident. The extent of the injury requires the patient to be hospitalized for the repair procedure, which involves extensive mobilization and rearrangement of the conjunctival tissue., A child presents with a severe conjunctival laceration caused by a sharp object. Given the complexity of the laceration and the patient's age, the physician determines that hospitalization is necessary for the surgical repair involving mobilization and rearrangement of the tissue.

Documentation should include the cause, location, and severity of the laceration, details of the mobilization and rearrangement performed, the method of closure (e.g., suture type), and the rationale for hospitalization.

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