Summary & Overview
CPT 68815: Nasolacrimal Duct Probing with Tube or Stent Placement
CPT code 68815 represents probing of the nasolacrimal duct with possible irrigation and insertion of a tube or stent to treat or evaluate obstruction. This ophthalmic procedure is used to diagnose strictures or obstructions in the tear drainage system and to restore or maintain tear outflow. Nationally, the code matters because it captures a commonly performed lacrimal procedure that impacts surgical utilization, ambulatory surgical center volumes, and ophthalmic specialty billing patterns. Key payers examined include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will gain a concise clinical and billing overview of CPT code 68815, including service context, typical sites of service, and common modifiers provided in the input. The publication summarizes benchmarking considerations, coding nuances relevant to ophthalmology and oculoplastics, and clinical context for when lacrimal probing with stent placement is performed. Data not available in the input is noted where applicable. The summary is intended for payers, coding professionals, and clinical leaders seeking a national-level brief on this specific lacrimal procedure code.
Billing Code Overview
CPT code 68815 describes a diagnostic and therapeutic lacrimal procedure in which the provider probes the nasolacrimal duct to identify an obstruction or stricture and may insert a tube or stent to maintain duct patency. The procedure may include irrigation of the duct but irrigation is optional.
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Service type: Diagnostic and therapeutic lacrimal duct probing with stent or tube placement
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Typical site of service: Ophthalmology or oculoplastic surgical setting; commonly performed in ambulatory surgical centers, hospital outpatient departments, or specialized ophthalmic clinics
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an ophthalmology or oculoplastic clinic with persistent epiphora (excessive tearing), recurrent dacryocystitis, or a history of nasolacrimal duct obstruction following trauma or prior sinus surgery. Initial evaluation includes history, external and slit-lamp exam, fluorescein dye disappearance test, and syringing/irrigation attempts in clinic. When probing and irrigation suggest a structural obstruction or recurrent stenosis, the patient is scheduled for a surgical nasolacrimal duct probing with intubation and silicone stent placement under local anesthesia with sedation or general anesthesia depending on age and cooperation.
Preoperative workflow includes consent, documentation of indication (e.g., chronic dacryocystitis, congenital or acquired nasolacrimal duct obstruction), pre-op clearance as needed, and selection of anesthesia. Intraoperative steps: dilation of puncta, probing the canaliculus and nasolacrimal duct to identify obstruction or stricture, optional irrigation, and insertion of a lacrimal intubation tube or stent to maintain duct patency. The provider documents laterality, technique, anesthesia, whether irrigation was performed, type of stent, and any complications. Postoperative care includes topical antibiotics, follow-up visits to assess stent position and lacrimal drainage, and planned stent removal typically after several months once patency is established.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard reporting |