CPT® Code 0563T

Official Description

Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral

Common Language Description

The procedure described by CPT® Code 0563T involves the evacuation of meibomian glands, which are specialized glands located within the eyelids. These glands play a crucial role in maintaining eye health by secreting oils that form a protective layer on the surface of the eye, thereby slowing the evaporation of tears and keeping the eyelids moist. Each eyelid contains a varying number of these glands, with the upper eyelid housing between 25 and 40 glands and the lower eyelid containing 20 to 30 glands. When these glands become blocked, they cease to secrete the necessary oils, leading to a condition known as Meibomian Gland Dysfunction (MGD). MGD is a significant contributor to dry eye syndrome, a common condition characterized by discomfort and visual disturbances due to insufficient tear film stability. Additionally, blocked meibomian glands can result in blepharitis, an inflammation of the eyelids. The evacuation procedure utilizes a combination of heat and manual expression to effectively address these blockages. An anesthetic eye drop is first administered to ensure patient comfort. Following this, a warming device is positioned between the upper eyelid and the cornea to deliver heat to both the inner and outer surfaces of the eyelid, facilitating the melting of the waxy buildup obstructing the glands. Subsequently, the clinician applies gentle manual pressure to the outer eyelid to assist in the removal of the blockage. Throughout the procedure, care is taken to protect the cornea, and the entire process is typically completed in less than 10 minutes.

1. Indications

The evacuation of meibomian glands using heat and manual expression is indicated for the following conditions:

Meibomian Gland Dysfunction (MGD) - A condition where the meibomian glands are blocked, leading to insufficient oil secretion and contributing to dry eye syndrome.
Dry Eye Syndrome - A common ocular condition characterized by discomfort and visual disturbances due to an unstable tear film, often associated with MGD.
Blepharitis - Inflammation of the eyelids that can occur as a result of blocked meibomian glands, leading to irritation and redness.

2. Procedure

The procedure for the evacuation of meibomian glands involves several key steps that are performed in a systematic manner to ensure effectiveness and patient comfort:

Step 1: Anesthetic Administration - The procedure begins with the application of anesthetic eye drops to the patient’s eyes. This step is crucial as it helps to minimize discomfort during the subsequent stages of the procedure.
Step 2: Application of Warming Device - A specialized warming device is then carefully positioned between the upper eyelid and the cornea. This device delivers controlled heat to both the inner and outer surfaces of the eyelid, which is essential for melting the waxy buildup that is clogging the meibomian glands.
Step 3: Manual Compression - After the waxy obstruction has been sufficiently softened by the heat, the clinician applies gentle manual pressure to the outer surface of the eyelid. This action aids in expressing the melted contents from the meibomian glands, effectively clearing the blockage.
Step 4: Corneal Protection - Throughout the procedure, special care is taken to protect the cornea from any potential damage, ensuring that the patient remains comfortable and safe during the treatment.
Step 5: Completion of the Procedure - The entire procedure is designed to be efficient, typically taking less than 10 minutes from start to finish, allowing for quick relief of symptoms associated with MGD and related conditions.

3. Post-Procedure

After the evacuation of meibomian glands, patients may experience immediate relief from symptoms associated with MGD and dry eye syndrome. It is important for patients to follow any post-procedure care instructions provided by the clinician, which may include avoiding eye makeup for a short period and using prescribed eye drops to maintain moisture. Patients should also be advised to monitor for any unusual symptoms, such as increased redness or discomfort, and to contact their healthcare provider if these occur. Regular follow-up appointments may be recommended to assess the effectiveness of the procedure and to determine if additional treatments are necessary.

Short Descr	EVAC MEIBOMIAN GLND HEAT BI
Medium Descr	EVACUATION MEIBOMIAN GLANDS USING HEAT BILATERAL
Long Descr	Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	STV-Packaged Codes
Berenson-Eggers TOS (BETOS)	none
MUE	1

GA	Waiver of liability statement issued as required by payer policy, individual case
79	Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
E2	Lower left, eyelid
GX	Notice of liability issued, voluntary under payer policy
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
LT	Left side (used to identify procedures performed on the left side of the body)
RT	Right side (used to identify procedures performed on the right side of the body)