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Conjunctivorhinostomy is a surgical procedure designed to address epiphora, which is characterized by excessive tearing due to obstructions in the upper lacrimal structures, specifically the punctum and canaliculi. This condition can significantly impact a patient's quality of life, leading to discomfort and potential complications if left untreated. During the procedure, an incision is made in the lower lid conjunctival sac, allowing the surgeon to raise mucosal flaps. The next critical step involves perforating the frontal process of the maxillary bone to create a direct passageway between the conjunctival sac and the nasal fossa. This connection facilitates the drainage of tears directly into the nasal cavity, thereby alleviating the symptoms associated with the blockage. It is important to note that this specific code, CPT® 68745, refers to the conjunctivorhinostomy performed without the placement of a tube, distinguishing it from similar procedures that may involve additional components such as tube insertion for enhanced drainage.
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Conjunctivorhinostomy is indicated for patients experiencing epiphora due to obstruction of the upper lacrimal structures. The following conditions may warrant this surgical intervention:
The conjunctivorhinostomy procedure involves several key steps to ensure successful creation of a passageway for tear drainage. The following outlines the procedural steps:
After the conjunctivorhinostomy procedure, patients may experience some swelling and discomfort in the surgical area. Post-operative care typically includes the use of prescribed analgesics to manage pain and anti-inflammatory medications to reduce swelling. Patients are advised to avoid strenuous activities and to follow up with their healthcare provider for monitoring the healing process. It is also important to maintain proper hygiene around the surgical site to prevent infection. The expected recovery time may vary, but most patients can anticipate a gradual improvement in symptoms as the surgical site heals and the new drainage pathway becomes functional.
Short Descr | CREATE TEAR DUCT DRAIN | Medium Descr | CONJUNCTIVORHINOSTOMY W/O TUBE | Long Descr | Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P4E - Eye procedure - other | MUE | 1 | CCS Clinical Classification | 19 - Other therapeutic procedures on eyelids, conjunctiva, cornea |
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Pre-1990 | Added | Code added. |