What does CPT code 68761 mean?
What does CPT code 68761 mean?
CPT code 68761 defines the “closure of the lacrimal punctum, by plug, each,” so additional modifiers that specify the lid—E1, upper left lid; E2, lower left lid; E3, upper right lid; E4, lower right lid—must be used when coding for punctal occlusion.
How do you bill for punctal plug removal?
Use 68761 (Closure of lacrimal punctum; by plug, each) to describe the professional service.
Does 68761 need a modifier?
A Medicare has assigned “E” modifiers to indicate which eyelid was treated. Most private payers and some Medicare contractors do not recognize these modifiers, but will accept RT (right eye) and LT (left eye) on the claim. Bilateral services may be reported as 68761-50.
How often will insurance pay for punctal plugs?
Replacement of silicone punctal plugs or other long-lasting plugs is generally not medically necessary more frequently than every 6 months; a more frequent replacement procedure may be medically necessary if the plug does not stay in place because the member fails to follow post-operative instructions.
Where do punctal plugs go?
The plugs are inserted into the tear duct opening (punctal) in the corner of your eye. This is the area where tears usually drain through the back of your nose and throat. The plugs form a blockade so the tears can’t flow out, keeping your eyes lubricated.
Why do my punctal plugs keep falling out?
Plugs that stick out. This is usually due to a plug being the wrong size. Plugs may rub against the surface of the eye or the eyelid, and can even fall out of the duct. This is one of the reasons doctors recommend regular checkups following the insertion.
What is the post op period for punctal plugs?
Allow at least 10 days (post-op period) following the insertion of collagen plugs before inserting permanent plugs. When occluding more than one punctum at the same time, the first procedure is allowed at 100% and each additional procedure is allowed at 50%.
