2025 CPT code 68340
(Active) Effective Date: N/A Revision Date: N/A Surgery - Conjunctivoplasty Procedures Surgical Procedures on the Eye and Ocular Adnexa Feed
Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens.
Modifiers may be applicable depending on the circumstances of the procedure, such as 50 (bilateral procedure), 51 (multiple procedures), 52 (reduced services), 22 (increased procedural services) and others.Appropriate modifier selection should align with the specific clinical scenario and payer guidelines. Consult the CPT guidelines for modifier application rules.
Medical necessity for a 68340 procedure is established when the symblepharon significantly impairs visual acuity, causes significant discomfort or dry eye, or limits the ability to open and close the eyelid fully.The procedure must be deemed necessary by the treating ophthalmologist and is subject to payer review.
The ophthalmologist or other qualified surgeon performs the procedure, including prepping the patient, administering anesthesia, excising scar tissue, separating the adhesions, suturing the tissues, and optionally inserting and later removing a conformer or contact lens.
- Surgical Procedures on the Eye and Ocular Adnexa
- Surgical Procedures on the Eye and Ocular Adnexa > Surgical Procedures on the Conjunctiva > Conjunctivoplasty Procedures
In simple words: This surgery fixes a problem where the inside lining of the eyelid is stuck to the surface of the eye. The surgeon separates the stuck tissues, removes scar tissue, and may use a small, clear shell or contact lens to keep the eyelid from sticking again. The shell or lens is taken out later.
This procedure involves the repair of a symblepharon, which is an adhesion between the conjunctiva of the eyelid and the conjunctiva of the eyeball.The surgeon frees or excises the scar tissue or adhesions between the palpebral and bulbar conjunctivae, dissecting fibrotic tissue away from healthy conjunctiva.The separated tissues are then advanced and secured with sutures. The symblepharon is divided, removing adhesions and scarring.A conformer or contact lens may be inserted between the lid conjunctiva and the globe to maintain separation, and it is removed at a later date. The procedure may also be performed without insertion of a conformer or contact lens.
Example 1: A patient presents with symblepharon due to a chemical burn injury. The surgeon performs a 68340 procedure to release the adhesions and improve the patient's ability to open and close their eye. A conformer is placed for several days to aid healing and prevent recurrence of the adhesion., A patient with a history of Stevens-Johnson syndrome develops symblepharon. The surgeon performs a 68340 procedure with the insertion of a conformer to prevent reattachment of the conjunctiva and to facilitate optimal eye lubrication., A patient presents with a minor symblepharon following trauma. The surgeon performs a 68340 procedure to release the adhesions without the need for conformer or contact lens placement, as the adhesion is minimal.
* Preoperative diagnosis and assessment of the symblepharon, including severity and location.* Detailed operative report outlining the surgical technique used, including the type of anesthesia, the extent of tissue released or excised, and whether a conformer or contact lens was used.* Postoperative plan of care, including instructions for follow-up care and potential complications.* Photographs of the symblepharon before and after the procedure may be helpful in documentation.
** The insertion of a conformer or contact lens is included in the code 68340 and should not be reported separately.The procedure should be coded based on whether a conformer or lens was placed.
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- RVU: Information not available in provided sources.RVUs vary by location and payer.
- Global Days: Information not available in provided sources. Global surgical days would need to be determined based on payer and local guidelines.
- Payment Status: Active
- Modifier TC rule: No information about a Technical Component (TC) modifier is found in the provided data. This would need to be determined based on local coding guidelines and payer requirements.
- Fee Schedule: Historical fee schedule information not available in the provided data. This would vary based on location, time period, and payer.
- Specialties:Ophthalmology
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)