Summary & Overview
CPT 67820: Correction of Trichiasis by Forceps Epilation
CPT code 67820 represents the correction of trichiasis by epilation using forceps, a procedure performed by ophthalmologists to remove misdirected eyelashes that pose a risk to ocular health. This code is nationally recognized and is relevant for providers and payers managing ophthalmic conditions that require precise, minimally invasive intervention. The procedure is typically conducted in an ophthalmologist's office and is distinct from other trichiasis correction methods that may involve different instruments or techniques.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare. The publication provides a comprehensive overview of clinical indications, billing benchmarks, and policy updates related to CPT 67820. Readers will gain insight into payer coverage, typical sites of service, and the clinical context for this procedure. Additionally, the report highlights relevant modifiers, associated taxonomies, ICD-10 diagnoses, and related CPT codes, offering a complete picture for stakeholders involved in ophthalmology billing and policy. This summary is designed to inform healthcare professionals, billing specialists, and policy analysts about the national landscape for trichiasis correction by forceps epilation.
CPT Code Overview
CPT 67820 is used to report the correction of trichiasis through epilation, performed exclusively with forceps. This procedure is a targeted intervention within ophthalmology to address abnormal eyelash growth that can cause irritation or damage to the eye. The typical site of service for this procedure is an ophthalmologist's office, most commonly designated as Place of Service 11. The code is specific to cases where forceps are the sole method used for epilation, distinguishing it from other approaches to trichiasis correction.
Clinical & Coding Specifications
Clinical Context
A patient presents to an ophthalmologist's office with complaints of irritation and discomfort in the eye, often described as a sensation of something rubbing against the eye surface. Upon examination, the ophthalmologist identifies trichiasis, which is the misdirection of eyelashes toward the cornea, without associated entropion. The affected eyelid may be the right upper, right lower, left upper, left lower, or unspecified. The ophthalmologist performs epilation using forceps to remove the offending eyelashes, providing relief from symptoms. This procedure is typically performed in the office setting and may be done on one or both eyes, depending on the extent of the condition.
Coding Specifications
- Modifier
50: Indicates a bilateral procedure when epilation is performed on both eyes during the same session.
| Modifier Code | Description |
|---|---|
50 | Bilateral procedure on both eyes |
- Provider Taxonomies: