Reimbursement for Treatment of Meibomian Gland Dysfunction

The meibomian glands are an important part of proper tear and eyelid function. They are located along the eyelid margin just behind the eyelashes.  These glands have openings that secrete meibum onto the surface of the eye and tears.  Meibum is an oily substance containing lipids and is important in the prevention of tear film evaporation.

Dysfunction involving the meibomian glands most often results in certain types of blepharitis or blockage to the glands.  Common patient complaints include: grittiness when blinking, chronic foreign body sensation, and dry eyes.

This FAQ addresses the following:

  1. What is meibomian gland dysfunction?
  2. What treatments are available to care for this condition?
  3. What documentation is required in the chart to justify a treatment for meibomian gland dysfunction?
  4. What about the Maskin Probe and Expressor as another treatment for meibomian gland dysfunction?
  5. Can CPT code 67700, blepharotomy, be used to code use of the Maskin Probe and Expressor?
  6. I saw Category III code 0207T as one option for treatment of meibomian gland dysfunction – what is that?
  7. What is the reimbursement for 67999 or 0207T?
  8. Is there a global period for meibomian gland dysfunction treatment?
  9. If coverage of treatment for meibomian gland dysfunction is unlikely or uncertain, how should we proceed?
  10. What should the ABN or financial waiver say in describing the reason for non-coverage?

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