Summary & Overview
CPT 68850: Contrast Injection into Tear Duct for Radiographic Imaging
CPT code 68850 denotes the injection of contrast material into the tear duct (lacrimal system) to improve visualization on radiographic imaging. This diagnostic service is commonly used in evaluation of lacrimal drainage disorders, obstruction, or persistent epiphora, and is relevant to ophthalmology and radiology practices nationwide. The code matters nationally because it defines coverage, billing, and clinical documentation expectations for a specialized diagnostic procedure that may be performed in outpatient radiology suites, hospital radiology departments, or ophthalmology clinics with imaging capability.
Key payers in this context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what the code represents, the typical clinical use and site of service, and what to expect in payer coverage discussions. The publication also summarizes common billing modifiers and practical considerations for claims processing, plus a concise clinical context for when lacrimal contrast injection is used.
What readers will learn: the clinical purpose of CPT code 68850, typical service settings, payer landscape nationally, and the billing context necessary to align documentation and coding for this diagnostic lacrimal imaging procedure.
Billing Code Overview
CPT code 68850 describes the injection of contrast material into the tear duct (lacrimal system) to enhance radiographic imaging. The procedure is performed to visualize the lacrimal drainage pathways during diagnostic dacryocystography or related radiographic studies.
Service Type: Diagnostic radiologic injection of the lacrimal system
Typical Site of Service: Outpatient radiology suite, hospital radiology department, or ophthalmology clinic with radiology capability
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Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents to the ophthalmology clinic with chronic epiphora (excessive tearing) and recurrent mucoid discharge in the right eye. Conservative measures including topical antibiotics and lacrimal hygiene provided limited relief. The ophthalmologist performs a diagnostic and therapeutic lacrimal duct irrigation with injection of radiopaque contrast material under fluoroscopy to evaluate for partial or complete nasolacrimal duct obstruction and to guide subsequent management (balloon dacryoplasty or dacryocystorhinostomy). The procedure is performed in an outpatient ambulatory procedure room or radiology suite, with topical anesthesia and sterile technique. Fluoroscopic imaging is obtained after injection of contrast into the punctum to document patency, level of obstruction, and any reflux into the canaliculi or nasal cavity. The imaging allows correlation with symptoms and planning of any additional surgical interventions. Typical documentation includes laterality, amount and type of contrast, fluoroscopic findings, patient tolerance, and any immediate complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the provider’s interpretation of fluoroscopic imaging separate from the facility’s technical component. |
50 |