Summary & Overview
CPT 67924: Extensive Repair of Lower Eyelid Entropion
CPT code 67924 designates an extensive surgical repair of entropion of the lower eyelid, a procedure intended to correct inward turning of the lid and lashes that can cause tearing, irritation, and corneal damage. Nationally, this code is used to capture operative care performed by ophthalmic surgeons and oculoplastic specialists in outpatient surgical settings. Accurate coding of 67924 affects clinical documentation, surgical case mix, and claims processing across major payers.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and typical service settings for the code, plus comparative benchmarks and payer coverage considerations where available. The publication also highlights common documentation elements associated with extensive entropion repair, reimbursement drivers tied to operative complexity, and relevant billing practice considerations.
This summary is intended for health policy analysts, coding staff, and clinicians seeking a national perspective on use and administrative handling of CPT code 67924, including expected sites of service and the clinical rationale for selecting this code for operative entropion management.
Billing Code Overview
CPT code 67924 describes an extensive repair of an entropion, a condition in which the lower eyelid and eyelashes turn inward toward the eye. The procedure corrects lid malposition to relieve excessive tearing, irritation, and potential corneal injury caused by lashes rubbing on the ocular surface.
Service type: Surgical repair (ophthalmic eyelid procedure)
Typical site of service: Outpatient ambulatory surgical center or hospital outpatient surgical department; may also be performed in an ophthalmology clinic with appropriate minor procedure setup
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old with symptomatic involutional lower eyelid entropion of the left eye causing corneal irritation, conjunctival injection, tearing, and occasional corneal epithelial defect despite conservative measures. The patient presents to an ophthalmic plastic surgery clinic after failed lubricating drops and temporary suture or Botox trial. The clinical workflow includes preoperative evaluation with ocular history, medication review, visual acuity, slit-lamp exam documenting inward rotation of the lower lid margin and trichiasis, informed consent, preoperative marking, local anesthesia with monitored sedation or MAC as needed, and performance of an extensive entropion repair (CPT 67924) addressing horizontal laxity, retractor disinsertion, and lid margin rotation (e.g., combined lateral tarsal strip, everting sutures, and retractor plication). Intraoperative documentation records laterality, specific techniques used, estimated blood loss, and any concurrent procedures. Postoperative care includes topical antibiotic/steroid drops, activity restrictions, wound care instructions, and follow-up visits to assess wound healing and ocular surface status. Typical site of service is an ambulatory surgery center or hospital outpatient department; the service type is reconstructive eyelid surgery for correction of eyelid malposition to protect the globe and restore function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |