Clinical Context
A typical patient is an adult or pediatric ophthalmology patient who presents with corneal exposure, persistent corneal epithelial defect, painful corneal erosion, or requires temporary immobilization of the eyelids following periocular surgery. For example, a 68-year-old patient with a large, nonhealing corneal epithelial defect after herpetic keratitis or a 45-year-old with severe eyelid trauma and a painful, exposed cornea may undergo temporary tarsorrhaphy. The clinical workflow includes a focused ophthalmic examination, topical or local anesthesia, placement of temporary sutures to partially or completely close the eyelids (procedure code 67875``), postoperative topical antibiotic or lubrication therapy, and scheduled follow-up visits to assess corneal healing and remove sutures when appropriate. Typical documentation includes indication, informed consent, anesthesia type, laterality, technique (temporary sutures), number and type of sutures, postoperative instructions, and follow-up plan.
Coding Specifications
- The most clinically relevant modifiers for
67875 are selected based on typical perioperative and administrative scenarios.
| Modifier | Description | When to Use |
|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when an E/M visit is performed and documented as distinct from the tarsorrhaphy on the same date. |
| 52 | Reduced services | Use when the procedure is partially reduced or not completed as planned.
| 53 | Discontinued procedure | Use when the procedure is started but halted due to unforeseen circumstances.
| 54 | Surgical care only | Use when only the surgical portion is billed and pre/postoperative care is billed by another provider.
| 55 | Postoperative management only | Use when billing only postoperative follow-up care for a procedure performed by another surgeon.
| 57 | Decision for surgery | (Not listed in input modifiers) Data not available in the input. |
| 58 | Staged or related procedure or service by the same physician during the post-operative period | Use when the tarsorrhaphy is planned as a staged procedure during the postoperative period of a related surgery.
| 59 | Distinct procedural service | Use when another distinct procedure is performed that is not normally reported together with 67875 on the same day.
| 62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the procedure.
| RT | Right side | Use to indicate the procedure was performed on the right eye when laterality is required.
| LT | Left side | Use to indicate the procedure was performed on the left eye when laterality is required.
| 50 | Bilateral procedure | Use when both eyelids/eyes are treated and payer requires bilateral modifier reporting.
| 22 | Increased procedural services | Use when the work required is substantially greater than typically required for 67875 and is well documented.
| 52 | Reduced services | Use when the service provided is less than described by the full code due to clinical reasons.
| Taxonomy Code | Specialty | Notes |
|---|
207L00000X | Ophthalmology | Most common specialty performing tarsorrhaphy. |
207K00000X | Oculoplastic Surgery | Subspecialists who manage eyelid/ocular surface reconstruction. |
363L00000X | Optometry | May perform in some jurisdictions under scope and co-management agreements; typically limited. |
2084P0800X | Emergency Medicine | Performs temporary tarsorrhaphy in acute trauma or exposure cases in ED settings. |
Related Diagnoses
- Common ICD-10 codes associated with temporary tarsorrhaphy.
| ICD-10 Code | Description | Clinical Relevance |
|---|
H16.221 | Central corneal ulcer, right eye | Corneal ulcers with risk of exposure or poor healing may be protected with temporary tarsorrhaphy. |
| H16.222 | Central corneal ulcer, left eye | Same relevance for the left eye.
| H18.02 | Band keratopathy, right eye | Ocular surface disease causing pain or epithelial compromise that may benefit from eyelid closure.
| H18.03 | Band keratopathy, left eye | Same relevance for left eye.
| H02.00 | Entropion and trichiasis of unspecified eyelid | Eyelid malpositions causing corneal irritation sometimes managed temporarily with closure.
| S05.2XXA | Injury of eyeball and orbital tissues, initial encounter | Acute trauma with corneal exposure or epithelial injury may require temporary tarsorrhaphy for protection.
| B00.50 | Herpesviral keratitis, unspecified | Recurrent or severe viral keratitis with poor epithelial healing can be an indication for temporary eyelid closure.
| H11.123 | Exposure keratoconjunctivitis, right eye | Direct indication when exposure leads to corneal compromise addressed by tarsorrhaphy.
Related CPT Codes
- Common CPT codes performed alongside or in the perioperative care of a temporary tarsorrhaphy are listed below.
| CPT Code | Description | Relationship to This Procedure |
|---|
65820 | Tarsorrhaphy, permanent with or without tarsal rotation | Alternative definitive procedure when permanent eyelid closure is required; may follow or replace temporary closure. |
| 67800 | Excision of lesion of eyelid (eg, chalazion); single lesion | Performed when excision of eyelid lesions is part of the same surgical episode before temporary closure for healing.
| 67850 | Closure of eyelid laceration; without repair of levator or canalicular system | Performed for traumatic eyelid repairs that may be accompanied by temporary tarsorrhaphy to protect the globe.
| 12002 | Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk; 2.5 cm or less | Generic simple repair code sometimes reported for periocular skin repairs in minor procedures accompanying tarsorrhaphy.
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | Example E/M codes used on the same day when 25 modifier applies for a distinct visit related to the eyelid/corneal condition.
| 99070 | Supplies and materials (except spectacles), used for more than usual in the office | Used when special dressings, amniotic membrane products, or other supplies are used along with the procedure.