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Dacryocystography is a specialized radiologic examination focused on the nasolacrimal ducts, which are the tear ducts responsible for draining tears from the eyes into the nasal cavity. This procedure is performed after the injection of a contrast medium, allowing for a detailed evaluation of the lacrimal drainage system. The primary purpose of dacryocystography is to investigate conditions associated with excessive tearing, which may indicate underlying issues such as blockages or other pathologies affecting the lacrimal system. Additionally, this examination is valuable for both pre-operative and post-operative assessments, providing critical information regarding the status of the nasolacrimal ducts before and after surgical interventions. During the procedure, anesthetic drops are applied to the patient's eyes to minimize discomfort. The lacrimal canaliculi, which are small channels that carry tears, are then cannulated, meaning a small tube is inserted to facilitate the injection of the contrast medium. This medium can be either water-soluble or oil-based, depending on the specific requirements of the examination. Once the contrast is injected, a series of radiographic images are captured at various angles, allowing the physician to visualize the entire lacrimal pathway. The interpretation of these images is crucial, as the physician looks for signs of pathology, including stenosis (narrowing of the ducts), blockages, abnormal growths, or the presence of fistulae (abnormal connections). Following the examination, a comprehensive written report detailing the findings is generated, which is essential for guiding further clinical decisions. It is important to note that CPT® Code 70170 specifically reports the components of radiologic supervision and interpretation associated with this procedure, rather than the entire dacryocystography process itself.
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The dacryocystography procedure is indicated for several specific conditions and symptoms related to the lacrimal drainage system. These include:
The dacryocystography procedure involves several key steps that are essential for obtaining accurate diagnostic images of the nasolacrimal ducts. These steps include:
After the dacryocystography procedure, patients may experience some temporary discomfort or irritation in the eyes due to the anesthetic drops and the cannulation process. It is important for patients to follow any post-procedure care instructions provided by their healthcare provider. Typically, there are no significant recovery requirements, and patients can resume normal activities shortly after the procedure. However, they should be advised to monitor for any unusual symptoms, such as increased tearing, redness, or swelling, and to report these to their physician if they occur. The findings from the dacryocystography will be discussed with the patient during a follow-up appointment, where further management or treatment options may be considered based on the results.
| Short Descr | X-RAY EXAM OF TEAR DUCT | Medium Descr | DACRYOCSTOGRAPY NASOLACRIMAL DUCT RS&I | Long Descr | Dacryocystography, nasolacrimal duct, radiological supervision and interpretation | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | 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 | T-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I1F - Standard imaging - other | MUE | 2 | CCS Clinical Classification | 226 - Other diagnostic radiology and related techniques |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 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 | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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