2025 CPT code 68530
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Feed
Removal of foreign body or dacryolith from the lacrimal passages.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (modifier 22), bilateral procedures (modifier 50), or other situations. Refer to current CPT coding guidelines for modifier usage.
Medical necessity must be established by documenting the symptoms, signs, or diagnostic findings related to the obstruction, such as excessive tearing, discharge, pain, or infection.If a foreign body is present, the documentation should clearly indicate its presence and location. For dacryoliths, imaging or other diagnostic evidence may be necessary to support the diagnosis.
The physician prepares the patient, administers anesthesia, makes an incision to access the lacrimal passages, removes the foreign body or dacryolith, controls bleeding, closes the incision with sutures, and monitors the patient post-procedure.
In simple words: The doctor removes something stuck in your tear duct, like a piece of dirt or a small stone, to help your tears flow properly.
This code describes a procedure where a foreign body (such as an eyelash, dirt particle, etc.) or a dacryolith (a stone-like formation in the tear duct) is removed from the lacrimal passages (tear ducts). This procedure is performed to alleviate blockage or obstruction of the tear ducts.
Example 1: A patient presents with a foreign body (e.g., an eyelash) lodged in the tear duct causing discomfort and tearing. The physician removes the foreign body using appropriate instruments under anesthesia., A patient experiences recurrent blockage and infection of the tear duct due to a dacryolith. The physician performs a surgical procedure to remove the dacryolith, restoring normal tear flow., A child has a persistent watery eye and discharge due to a blocked tear duct. A small tube (Crawford tube) was previously inserted to alleviate the blockage. Following the appropriate healing period, the physician removes the Crawford tube.
Documentation should include the type of foreign body or dacryolith, the location within the lacrimal passages, the method of removal, anesthesia used, and any complications encountered.If a Crawford tube is being removed, documentation of prior insertion and the indication for removal is necessary.
** It is important to note that the removal of Crawford tubes can sometimes be considered part of a broader evaluation and management (E/M) service and might not be separately billable.Payer policies regarding Crawford tube removal and the appropriateness of using code 68530 can vary, so it's crucial to verify coverage and coding guidelines with the specific payer.
- Payment Status: Active
- Specialties:Ophthalmology, Optometry
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center