A4263 Permanent tear duct plug
Also known as: permanent plug, tear duct plug, silicone plug
Permanent Tear Duct Plug, a semi-permanent occlusive device for chronic tear duct occlusion in severe dry eye syndrome management.
In Plain Language
eye duct plug; permanent tear blocker
Clinical Context
Surgically placed in patients with severe dry eye unresponsive to medical therapy to permanently preserve tears.
RVU Information
CPT A4263 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
HCPCS A-codes cover medical supplies, equipment, and transport services. Documentation must establish medical necessity and include a physician order. For durable medical equipment (DME), a Certificate of Medical Necessity (CMN) or detailed written order may be required.
Specialties
Frequently Asked Questions
What is CPT code A4263?
CPT A4263 (Permanent tear duct plug) is a A Codes code. Permanent Tear Duct Plug, a semi-permanent occlusive device for chronic tear duct occlusion in severe dry eye syndrome management.
Does Medicare cover A4263?
Medicare coverage for A4263 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Surgically placed in patients with severe dry eye unresponsive to medical therapy to permanently preserve tears. A physician order is typically required.
When is CPT A4263 used?
Surgically placed in patients with severe dry eye unresponsive to medical therapy to permanently preserve tears.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.