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Condition
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Procedure
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Procedure Note
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Chalazion - 67800
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Punctal Plugs
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Dilation and irrigation
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Eyelid lesion removal
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Pterygium - RIGHT EYE
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Pterygium - LEFT EYE
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I-Stent - RIGHT EYE
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I-Stent - LEFT EYE
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Chalazion Excision EYE
• • •
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Chalazion note standard
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|
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Eyelid lesion removal
• • •
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Eyelid lesion removal CODING
• • •
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Eyelid lesion EXCISION
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Eyelid CYST removal
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Dilation and irrigation - EYE
• • •
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Dilation/irrigation OU, normal
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Dilation/irrigation, REFLUX OU
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Dilation/irrigation OD, normal
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Dilation/irrigation, REFLUX OD
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Dilation/irrigation OS, normal
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Dilation/irrigation, REFLUX OS
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Punctal plugs - EYE
• • •
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Additional notes
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Additional notes 2
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General Consent On
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Name and relation if not patient signing
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Signature
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