Wiki eye question-dacryocystorhinostomy

[Jamie Dezenzo]

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Hello all,
doctor makes dacryocystorhinostomy incision,elevated to bridge of nose and posterior lacrimal crest. Bony ostium was created w/ rongeurs. Nasal mucosal window was created w/ electrocautery. Lacrimal sac then opened and marsupialized then the crawford stents were placed via the superior and inferior canaliculi.


would this be 68720 w/ 68815 or more like 68750? Any thoughts!


THANKS!

 

[magnolia1]

If the doctor is calling this a DCR, I would go with 68720 alone.

Karen Maloney, CPC
Data Quality Specialist

 

[Jamie Dezenzo]

Yes, doctor is calling it DCR and thanks for your input Karen

 

[Jamie Dezenzo]

Fyi-cpt asst 2009

Year: 2009

Issue: August

Pages: 9&11

Title: Coding Consultation: Questions and Answers


Surgery–Eye and Ocular Adnexa

We received two questions pertaining to the following surgical intervention: Lacrimal puncta are dilated (68801), after which scissor punctoplasty is performed (68440). Canaliculi are probed and obstructions found within the canaliculi are dilated with the probe (68840). A dacryocystorhinostomy (DCR) is then performed (68720), after which silicone tubes are placed through the rhinostomy (included in DCR). Middle turbinate is partially
excised (30999).

Question 1o the more distal lacrimal tract procedures make this a conjuntivodacryocystorhinostomy (68750) or would they be separately coded, in addition to the DCR (68720) as above?

Answer:The procedural description provided is -definitely not a conjuntivodacryocystorhinostomy (68750). Moreover, a probing is always performed with a con-juntivodacryocystorhinostomy, and is thus, not
reported separately.

Question 2:Is the silicone intubation through the new nasolacrimal opening included in code 68720 or is there a different code for it, and can code 68815 possibly be used?

Answer:The silicone intubation is not included in the work description of code 68720,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity).Although the additional work is minimal, it would be appropriate to separately report code 68815,Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent.