Summary & Overview
CPT 67930: Eyelid Wound Closure with Direct Suturing
CPT code 67930 represents direct closure (suturing) of a recent eyelid wound that does not completely penetrate the eyelid but may involve the eyelid margin, lining membrane, or inner plate. This code is used to bill for minor surgical repair of superficial eyelid lacerations and is relevant across ambulatory surgical centers, physician offices, and emergency departments where ophthalmic or oculoplastic care is delivered. Nationally, accurate coding for eyelid wound closure affects procedure documentation, appropriate site-of-service reporting, and consistent clinical billing for ophthalmology and emergency medicine practices.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, payer coverage considerations, common modifiers that may apply in claims, and benchmarks where available. The publication outlines coding boundaries for this procedure, typical settings where the service is performed, and practical billing elements to support claim submission and reimbursement workflows. Data not available in the input is noted where payer-specific payment amounts, associated taxonomies, and ICD-10 diagnoses would normally appear.
Billing Code Overview
CPT code 67930 describes closure of a recent eyelid wound that does not fully penetrate the eyelid. The service involves direct suturing of the wound edges and may address involvement of the eyelid margin, lining membrane, or inner plate.
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Service type: Minor surgical wound closure of the eyelid (direct closure)
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Typical site of service: Ambulatory surgical center, physician office, or emergency department depending on clinical setting
Clinical & Coding Specifications
Clinical Context
A patient presents to an ophthalmology or emergency department after sustaining a recent partial-thickness eyelid laceration from blunt trauma (e.g., fall, pet bite, or glass injury). The eyelid wound does not traverse the full thickness of the lid but involves the skin and/or tarsal edge and may involve the palpebral conjunctiva or eyelid margin. The provider performs an exam under adequate anesthesia, irrigates and debrides the wound if needed, approximates eyelid margin and layered tissues, and performs a direct primary closure with fine interrupted or running sutures to restore eyelid contour and function. Typical workflow includes pre-procedure consent and time‑out, local or monitored anesthesia, layered suturing of skin and mucocutaneous edges, application of antibiotic ointment and dressings, and post‑procedure instructions with scheduled follow‑up for suture removal and eyelid function assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable E/M service by the same physician on the same day of a procedure | Use when a distinct evaluation or management visit is documented on the same day as 67930 (note: 25 is not in the provided modifier list; adherence to provided modifiers required). |