2025 CPT code 67975
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Reconstruction of eyelid, full thickness, by transfer of tarsoconjunctival flap from opposing eyelid; second stage.
Modifiers E1-E4 (to specify the eyelid involved), 50 (bilateral procedure), and other modifiers as clinically appropriate, should be used according to the official CPT guidelines.
Medical necessity is established by the presence of a full-thickness eyelid defect that impairs eyelid function and/or cosmetic appearance.The documentation should clearly demonstrate the need for reconstruction, including the extent of the defect and its impact on the patient's vision, eyelid closure, and overall quality of life.
The clinical responsibility includes preparing the patient, administering anesthesia, carefully dissecting and transferring the tarsoconjunctival flap from the donor eyelid to the recipient eyelid, hemostasis (controlling bleeding), and wound closure. Postoperative care and monitoring are also part of the clinical responsibility.
In simple words: This code represents the second part of a two-part surgery to fix a severely damaged eyelid.The surgeon takes a piece of tissue from the other eyelid and uses it to rebuild the damaged one. This improves both the look and function of the eye.
This CPT code 67975 describes the second stage of a two-stage eyelid reconstruction procedure.It involves a full-thickness reconstruction of the eyelid where a tarsoconjunctival flap is transferred from the opposing eyelid to the affected eyelid. This is a complex procedure aimed at restoring both the cosmetic appearance and functional integrity of the eyelid. The procedure is performed after the initial preparation and placement of a flap closure in a previous session.
Example 1: A patient presents with a full-thickness lower eyelid defect due to a previous trauma. The surgeon performs this procedure in two stages. First, the flap is created and secured. Second, this code is billed for the transfer and final reconstruction., A patient undergoes Mohs surgery for removal of a basal cell carcinoma on the upper eyelid.Significant tissue is removed, requiring full-thickness reconstruction. The surgeon uses a tarsoconjunctival flap from the lower eyelid, billing this code for the second surgical stage., A patient sustains a severe burn injury affecting the lower eyelid.The initial stage involved flap preparation and placement. This code would be used to bill for the subsequent stage, where the flap is transferred, and the eyelid is completely reconstructed.
Detailed operative notes describing the procedure, including the specific technique used for flap transfer, the size and location of the defect, and the type of tissue transferred.Preoperative and postoperative photographs, including images of the defect and the reconstructed eyelid.Any complications encountered during or after the surgery must be documented.
** This is a complex procedure often requiring significant surgical expertise.The choice of using a tarsoconjunctival flap versus other reconstruction techniques depends on the specific characteristics of the defect, available tissue, and surgeon preference.Accurate documentation is essential to justify medical necessity and ensure proper reimbursement.
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- RVU: Information not provided.
- Global Days: Information not available in provided data.
- Payment Status: Active
- Modifier TC rule: Information not available in provided data.
- Fee Schedule: Information not available in provided data.
- Specialties:Ophthalmology, Plastic Surgery, Oculoplastic Surgery
- Place of Service:Ambulatory Surgical Center, Office, Hospital (Inpatient or Outpatient)