Q: What is gold weight placement in the upper eyelid and how would I code that procedure?
A: It is not uncommon for patients diagnosed with lagophthalmos to have a gold weight implanted in the upper eyelid. Lagophthalmos is the inability to fully close the upper eyelid and/or poor closure of the upper eyelid. This condition is usually secondary to another problem such as Bells Palsy and may occur after a stroke, trauma, bacterial infection, or neurosurgery involving the cranial nerves. Patients may suffer from severe dryness of the eyes, corneal tears, ulcerations, and decreased vision.
Otolaryngologists perform gold weight placement in the upper eyelid to correct lagophthalmos, usually after other treatments have been unsuccessful. Typically, this outpatient procedure is performed in a hospital operating room or freestanding surgical center. With the patient under local anesthesia, the surgeon makes a small incision in the upper eyelid above the eyelashes and creates a pouch for the gold weight to sit. The implant is then placed in the pocket and secured with sutures. The incision is closed and a protective patch covers the area. The code for billing gold weight placement in the upper eyelid is CPT code 67912, “Correction of lagophthalmos, with implantation of upper eyelid load e.g., (gold weight).”
Reviewed April 2008
Reviewed March 2010
Important Disclaimer Notice (Updated 8/7/14)
CPT for ENT articles are a collaborative effort between the Academy’s team of CPT Advisors, members of the Physician Payment Policy (3P) workgroup, and health policy staff. Articles are developed to address common coding questions received by the health policy team, as well as to clarify coding changes and correct coding principles for frequently reported ENT procedures. These articles are not intended as legal, medical, or business advice and are not a guarantee of reimbursement. The information is also not meant to serve as the definitive or sole authority on billing and coding issues. The applicability of AAO-HNS billing and coding guidance for a particular procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. You should consult with your own advisors as well as Medicare or private carriers in making any decisions about how to bill and code particular services or procedures.