Summary & Overview
CPT 67922: Thermocauterization Repair of Lower Eyelid Entropion
CPT code 67922 represents thermocauterization repair of lower eyelid entropion, a minor ophthalmic surgical procedure intended to correct inward turning of the eyelid and lashes that can cause tearing and ocular irritation. Nationally, this code is relevant to ophthalmologists, ambulatory surgical centers, and payers managing outpatient eye procedures because entropion repair addresses patient symptoms and prevents corneal complications that may lead to more intensive care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical settings where the service is performed, and an outline of payer coverage considerations. The publication summarizes common modifiers associated with surgical billing and flags where structured coding and documentation are important for proper claim adjudication.
This report helps administrators and billing professionals understand the clinical intent of CPT code 67922, the typical care pathway for patients requiring entropion repair, and the payer landscape that commonly reimburses outpatient ophthalmic procedures. Data not available in the input is noted where applicable, and readers are guided to review payer-specific policies for coverage criteria and preauthorization requirements.
Billing Code Overview
CPT code 67922 describes a procedure in which the provider uses thermocauterization to repair an entropion, an inward turning of the lower eyelid and eyelashes that can cause tearing and corneal irritation. The procedure is a minor ophthalmic surgical service focused on correcting eyelid malposition to reduce ocular surface irritation and protect the cornea.
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Service type: Minor ophthalmic surgical procedure (thermocauterization for eyelid repair)
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Typical site of service: Outpatient ophthalmology clinic or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult presenting to an ophthalmology clinic with complaints of chronic ocular irritation, foreign body sensation, tearing (epiphora), and eyelash-related corneal or conjunctival irritation. Examination reveals an inward turning of the lower eyelid margin with lashes contacting the ocular surface consistent with entropion. Conservative measures (lubricating drops, eyelid taping) have been attempted or are insufficient. The patient is scheduled for an outpatient minor surgical procedure under local anesthesia with or without monitored anesthesia care. The provider uses thermocauterization of the lower eyelid margin to scar and reposition the lid margin, reducing lash contact and improving symptoms. Typical workflow: preoperative consent and history, topical and local anesthesia, sterile preparation, placement of eyelid traction, application of thermocautery to the affected tarsal or mucocutaneous margin, hemostasis, postoperative topical antibiotic ointment and instructions, and short follow-up within 1–2 weeks to assess healing and eyelid position.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician professional component is reported separately from technical components. |
50 |