Punctal plugs codes

from: http://www.ocusoft.com/OcclusionTherapyRateCharts/CaiforniaRestofState.pdf

Diagnostic Codes used to characterize Lacrimal System Dysfunction:

• Tear Film Insufficiency 375.15
• Keratoconjuctivitis Sicca 370.33
  Redness or Discharge 379.93
• Pain in or around eye 379.91

1st VISIT (LO1) - Lacrimal EfficiencyTesttm with dissolvable Collagen / CollaSyn™ test plugs in upper and lower puncta

• Occlude left upper punctum with test plug 68761-E1
• Occlude left lower punctum with test plug 68761-E2
• Occlude right upper punctum with test plug 68761-E3
• Occlude right lower punctum with test plug 68761-E4
• 10 Day Post-Operative Period

2nd VISIT (LO2) - Non-Dissolvable or 6 Month Dissolvable VisiPlug™ Lacrimal Plugs in upper puncta, re-test lower puncta

• Occlude left upper punctum 68761-E1
• Occlude right upper punctum 68761-E3
• Occlude left lower punctum with test plug 68761-E2
• Occlude right lower punctum with test plug 68761-E4
• 10 Day Post-Operative Period

3rd VISIT (LO3) - 6 Month Dissolvable VisiPlug™ Lacrimal Plugs® in lower puncta

• Occlude left lower punctum 68761-E2 3
• Occlude right lower punctum 68761-E4 3
  

RELATED CPT CODES

• Probing of canaliculi, with / without irrigation,Plug Repositioning or Removal (L04, L05) 68840
• Dilation of punctum, with / without irrigation, Plug Removal (LO5) 68801
• Probing of nasolacrimal duct, with / without irrigation, Plug Removal (LO5) 68810