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Dacryocystography is a specialized radiologic examination that focuses on the nasolacrimal ducts, commonly known as tear ducts. This procedure is performed to evaluate conditions such as excessive tearing and to assess the patency, or openness, of the lacrimal drainage system, as well as to identify any underlying pathology. The examination involves the injection of a contrast medium, which enhances the visibility of the lacrimal pathways during imaging. Dacryocystography is particularly useful for both pre-operative and post-operative evaluations, allowing healthcare providers to gather critical information regarding the functionality of the lacrimal system. Prior to the procedure, patients may undergo panoramic radiography of the face, which can be reported separately. The procedure begins with the instillation of anesthetic drops into the eyes to minimize discomfort. Following this, the lacrimal canaliculi are cannulated, allowing for the injection of either a water-soluble or oil-based contrast medium. Radiographic images are then captured at various oblique angles to provide a comprehensive view of the lacrimal pathways. It is important to note that CPT® Code 68850 specifically reports the injection of the contrast medium and the necessary cannulation involved in this procedure, rather than the imaging itself.
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The indications for performing dacryocystography include the following:
The procedure for dacryocystography involves several key steps, which are detailed as follows:
After the dacryocystography procedure, patients may experience some temporary discomfort or tearing as a result of the contrast medium injection. It is important for healthcare providers to monitor the patient for any adverse reactions. Patients are typically advised to avoid rubbing their eyes and to follow any specific post-procedure care instructions provided by their healthcare provider. Follow-up appointments may be scheduled to discuss the results of the imaging and any further necessary interventions based on the findings.
| Short Descr | INJECTION FOR TEAR SAC X-RAY | Medium Descr | INJECTION CONTRAST MEDIUM DACRYOCYSTOGRAPY | Long Descr | Injection of contrast medium for dacryocystography | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | 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) | 1 - Statutory 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | I1F - Standard imaging - other | MUE | 1 | CCS Clinical Classification | 226 - Other diagnostic radiology and related techniques |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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.) | 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) | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| Pre-1990 | Added | Code added. |
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