Summary & Overview
CPT 67835: Excision of Trichiasis with Eyelid Margin Skin Graft
CPT code 67835 covers surgical excision of lash-bearing eyelid margin tissue to treat trichiasis, followed by reconstruction using a skin graft of similar tissue. The procedure addresses symptomatic lashes that abrade the ocular surface and can prevent chronic irritation, corneal scarring, and vision complications when conservative measures fail. Nationally, this code denotes a specialty ophthalmic reconstructive service performed in operative settings and is relevant for surgical practices, ambulatory surgical centers, and hospital outpatient departments.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing-focused overview of CPT code 67835, including its clinical indication, typical service setting, and the kinds of documentation and procedure descriptors that are commonly associated with this service. The publication also outlines common modifiers and related billing considerations, presents benchmark context where available, and summarizes policy or coverage themes relevant to reconstructive eyelid procedures. This resource is intended to help coding professionals, surgical providers, and revenue cycle staff understand the clinical purpose of the code and the payer landscape impacting its use.
Data not available in the input for associated taxonomies, specific ICD-10 pairings, and payer-specific coverage rules.
Billing Code Overview
CPT code 67835 describes surgical removal of deviated or abnormal eyelashes (trichiasis) with excision of eyelid margin tissue and closure using a skin graft of like tissue (for example, graft harvested from the lip). This procedure is intended to eliminate lashes that cause corneal or conjunctival irritation by removing the offending lash-bearing tissue and reconstructing the eyelid margin.
Service Type: Surgical ophthalmic procedure — eyelid margin reconstruction with grafting
Typical Site of Service: Operating room or procedure suite (ambulatory surgical center or hospital outpatient setting depending on clinical context and facility resources).
Clinical & Coding Specifications
Clinical Context
A 62-year-old female presents to an ophthalmic plastic surgery clinic with chronic ocular irritation, tearing, and recurrent corneal abrasions caused by inward-turning eyelashes (trichiasis) of the lower eyelid. Conservative measures including epilation and lubricating drops have failed. After examination and discussion, the oculoplastic surgeon schedules definitive surgical management: excision of the aberrant lash-bearing tissue (marginal eyelid excision) with reconstruction of the eyelid margin utilizing a full-thickness skin graft harvested from the oral mucosa or nearby eyelid skin to restore lid contour and protect the cornea.
Preoperative workflow includes informed consent, photographic documentation of the lid margin and cornea, medical clearance as indicated, and marking the donor and recipient sites. The procedure is typically performed in an ambulatory surgery center or outpatient ophthalmology operating room under local anesthesia with monitored sedation or general anesthesia depending on patient factors. Postoperative care includes topical antibiotics, lubricants, follow-up for graft check, and instructions to avoid trauma to the surgical site.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | Use if a distinct E/M visit is documented the same day as the procedure (Note: 25 was not in input list; per strict rules do not add modifiers not provided.) |