Summary & Overview
CPT 67808: Excision of Chalazia Under General Anesthesia
CPT code 67808 covers the surgical excision of one or multiple chalazia from the eyelid performed under general anesthesia. This code is used primarily when patients — often young children or uncooperative individuals — cannot tolerate procedures under local anesthesia. Nationally, correct use of this code ensures accurate classification of surgical eyelid procedures that require an anesthetized setting and supports appropriate claims processing and resource allocation.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical context and service setting, typical payer coverage considerations, and the types of benchmarks and policy updates that affect billing and reimbursement for anesthetized ophthalmic minor surgery. The publication outlines common billing modifiers associated with surgical services and anesthesia, discusses where the procedure is typically performed (operating room or ambulatory surgery center), and highlights areas where policy or documentation clarity can affect payment. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 67808 describes the surgical removal of one or more chalazia (small, localized eyelid masses) performed under general anesthesia. The procedure is typically used when patients are young, uncooperative, or otherwise unable to tolerate removal under local anesthesia.
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Service type: Surgical excision of eyelid lesion(s) under general anesthesia
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Typical site of service: Operating room or ambulatory surgery center where general anesthesia can be administered
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Clinical & Coding Specifications
Clinical Context
A 4-year-old child presents to the ambulatory surgical center with a persistent, enlarged chalazion of the upper eyelid that is painful and interfering with eyelid function. Due to the patient’s age and inability to cooperate with local anesthesia, the ophthalmologist schedules incision and drainage of one or multiple chalazia under general anesthesia (CPT 67808). Preoperative evaluation includes a focused history and physical, verification of fasting status, anesthesia assessment, and consent from the legal guardian. In the operating room, a general anesthetic is induced by the anesthesia team, standard sterile preparation is performed, and the surgeon identifies and removes the chalazion(s) via incision and curettage or excision as clinically indicated. Hemostasis is obtained, and the eyelid is dressed. Postoperative recovery includes monitoring in the PACU until the child meets discharge criteria; discharge instructions address wound care, activity limitations, and signs of infection. A follow-up visit is scheduled in 1–2 weeks to assess healing and visual function. Typical site of service is an ambulatory surgery center or hospital outpatient department where general anesthesia services are available. Service type: minor surgical ophthalmic procedure performed under general anesthesia for pediatric or uncooperative patients.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia |