Wiki Excision of accessory puncta cpt code??

pjacobs

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Excision of accessory puncta, right eye

With the silicone tube in place, a #0 nasolacrimal duct probe was passed through the accessory puncta to note it's course to the lacrimal sac. A marking pen was used to outline an ellipse shaped incision area around the accessory puncta. A microblade was used to make a skin incision along the pre-determined area. Forceps and Wescott scissors were used to carefully dissect the incised area from the underlying soft tissue. The accessory puncta and its connecting cannaliculus was visualized entirely to avoid excision prior to securing the area around the lacrimal sac. A 6-0 Vicryl suture was tied around the cannaliculus at the sac junction. Once the proximal tube was secured, the entire accesory area was excised. The probe was attempted to be passed into the sac, but was unable through the tied off area. Caudery was used to scar down the residual canal. Several 6-0 Vicryl suture was used to securely close deep tissue over the area, followed by 6-0 plain gut suture to close overlying skin.

My physician is giving me the code 68700 but I feel that 68770 would better suit this... Can you give me your input on this? Thanks so much!
 
No lacrimal fistula.. it just seems as close as I can get to the accessory puncta. Thanks for the input.
 
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