Summary & Overview
CPT 68810: Nasolacrimal Duct Probe with Possible Irrigation
CPT code 68810 denotes probing of the nasolacrimal duct to detect obstruction or stricture, with optional irrigation. Nationally, this code captures a common diagnostic procedure used by ophthalmologists and related specialists to evaluate patients with excessive tearing or suspected lacrimal drainage issues. Accurate coding for 68810 is important for appropriate clinical documentation, care pathway tracking, and payment alignment for outpatient ocular procedures.
This analysis covers major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when 68810 is used, typical sites of service, and the scope of services captured by the code. The publication highlights benchmarking and reimbursement context, common billing considerations, and any relevant recent policy updates affecting outpatient lacrimal procedures. The goal is to provide clinicians, billing professionals, and policy analysts with a concise reference to support consistent use of CPT code 68810 in national practice settings.
Billing Code Overview
CPT code 68810 describes a diagnostic procedure in which the provider probes the nasolacrimal duct to identify a possible obstruction or stricture; the provider may or may not irrigate the duct. This service is typically performed by ophthalmologists or otolaryngologists as part of evaluation for epiphora (excess tearing) or suspected lacrimal outflow obstruction.
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Service type: Diagnostic lacrimal probe and possible irrigation
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Typical site of service: Ophthalmology clinic, outpatient surgery center, or office setting where minor lacrimal procedures are performed
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric patient presenting to an ophthalmology or oculoplastic clinic with epiphora (excess tearing), recurrent dacryocystitis, or suspected nasolacrimal duct obstruction. The clinician performs an external exam, lacrimal dye disappearance test or irrigation in clinic, and reviews imaging if indicated. When probing is indicated, the patient is taken to a procedure room or ambulatory surgery center; topical or local anesthesia with or without mild sedation is provided. The provider advances a lacrimal probe through the punctum into the canaliculus and nasolacrimal duct to identify a partial or complete obstruction or stricture. The provider may record whether irrigation was performed, whether a passage was established into the nasal cavity, and whether a stent or balloon dilation is required in a subsequent session. Typical documentation includes indication, informed consent, anesthesia, laterality, technique (probe sizes and whether irrigation performed), findings (site of obstruction), and post-procedure plan (antibiotics, stent placement, referral for dacryocystorhinostomy if probing fails).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Principal physician of record or primary surgeon | Use when the reporting provider is the primary surgeon performing the procedure. |
22 |