Ophthalmology and Optometry Coding Alert

Question: What is the proper code to use for fitting and placement of an orbital conformer under general anesthesia?

Delaware Subscriber

Answer: It depends on the situation in which you are placing the orbital conformer (a shell sometimes used as a temporary false eye after eye removal, which helps to preserve the shape of the eyelids). If you are placing the conformer as part of an enucleation or evisceration procedure, you would not bill separately for the procedure it would be included in the surgical code. Because an orbital conformer is a temporary implant, when billing the surgical procedure you would select the code that states in its description without implant.

The two codes are 65091 (evisceration of ocular contents; without implant) and 65101 (enucleation of eye; without implant). When placing a permanent implant, use the codes that describe with implant to report the service. If you are placing the conformer for the repair of symblepharon, which is an adhesion between conjunctival surfaces that may be caused by inflammation, trauma or previous surgery, you should use 68340 (repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens).