2025 CPT code 67835
Effective Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Feed
Correction of trichiasis; incision of lid margin, with free mucous membrane graft.
Modifiers such as -LT (left side), -RT (right side), -50 (bilateral procedure), and -22 (increased procedural services) may be applicable when appropriate.
Medical necessity for 67835 is established when trichiasis causes significant discomfort, corneal irritation, abrasions, or ulcers, or poses a threat to vision. Conservative treatments, such as epilation, should be documented as having failed or being unsuitable before resorting to surgery. The documentation must clearly demonstrate the functional impairment caused by the trichiasis.
The ophthalmologist or oculoplastic surgeon performs the procedure, which involves making an incision, removing the affected eyelashes and follicles, harvesting and preparing the mucous membrane graft, and carefully suturing the graft in place.
In simple words: This surgery fixes ingrown eyelashes by removing them and replacing the skin where they grew with a small graft from inside your cheek.
This code describes a surgical procedure to correct trichiasis, a condition where eyelashes grow inwards towards the eye.The procedure involves an incision of the eyelid margin and the removal of the misdirected eyelashes and their roots. A free mucous membrane graft, often taken from the buccal mucosa (inside of the cheek), is then used to cover the resulting defect and promote proper healing, preventing further misdirection of eyelash growth.
Example 1: A patient with severe trichiasis causing corneal abrasions and pain despite conservative management undergoes surgery with code 67835 to permanently correct the misdirected eyelashes and prevent further corneal damage., A patient with recurrent trichiasis after multiple epilation attempts requires a more permanent solution. The surgeon performs a procedure using code 67835 with a buccal mucous membrane graft to reduce the likelihood of recurrence., A patient with trichiasis secondary to chemical burn injury and subsequent scarring undergoes reconstructive eyelid surgery using code 67835 in conjunction with other procedures to address both the trichiasis and eyelid malposition.
Documentation should include the diagnosis of trichiasis, the severity and location of the affected eyelashes, prior treatments attempted, the source of the mucous membrane graft, details of the surgical procedure, and any complications encountered. Evidence of medical necessity, such as corneal damage or persistent pain, should also be documented.
** For cases where a different graft material is utilized, other codes may be more appropriate. Always refer to current CPT guidelines.
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- Specialties:Ophthalmology, Oculoplastic Surgery
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient Department, Physician's Office