2025 CPT code 68745

Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube.

Do not report 69990 in addition to codes 65091-68850.For removal of foreign body, see 65205 et seq.

Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), bilateral procedures (50), or reduced services (52).

Medical necessity is established by the presence of a blocked tear duct causing epiphora (excessive tearing) that has not responded to conservative management.

The surgeon performs a circular incision in the medial canthal area, exposes the bone, drills a hole into the nasal bone, and creates a tract between the conjunctiva and nasal mucosa by suturing flaps.The surgeon monitors for bleeding and observes the patient post-procedure.

IMPORTANT For a similar procedure with tube insertion, use 68750.

In simple words: This surgery creates a new channel for tears to drain from the eye into the nose. It's done when the normal tear ducts are blocked, causing watery eyes.

This procedure establishes a new drainage pathway for tears by creating a fistula (tract) between the conjunctiva and the nasal cavity. It is typically performed to address excessive tearing due to complete blockage of the tear ducts (punctum and canaliculi).

Example 1: A patient experiences excessive tearing due to a blocked tear duct. A conjunctivorhinostomy without tube insertion is performed to create a new drainage pathway., A child has congenital nasolacrimal duct obstruction, and other treatments have failed. The ophthalmologist performs a 68745 to alleviate the tearing., Following trauma to the medial canthus, a patient's tear duct is damaged and blocked. Reconstructive surgery includes a conjunctivorhinostomy to restore tear drainage.

Documentation should include the medical necessity for the procedure, such as failed prior treatments, the location and nature of the blockage, the surgical technique employed, and any complications encountered.

  • Revenue Code: P4E (EYE PROCEDURE - OTHER)
  • Specialties:Ophthalmology
  • Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Inpatient Hospital (if required by complexity or patient condition)
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