Clinical guide · Punctal occlusion
Punctal Plugs Plug types, sizes, pack counts and coding.
Use this page to pick a plug family, read each manufacturer's size chart, confirm how many plugs ship in a pack and code the procedure. EagleVision, Lacrivera and OASIS plugs are all stocked in the Vision Rescue punctal plug category.
Start with the plug family and how long it lasts.
Each family sits in the canaliculus differently, so plan around the duration printed on the product.
Collagen
Short-term inserts that dissolve. How long a plug occludes and how long it takes to fully absorb are not the same thing, so go by the product's stated duration.
Synthetic absorbable
Longer temporary occlusion. OASIS Extended Duration lasts up to 90 days and the OASIS 180 line up to 180 days, and Vera90 is labeled for 60 to 180 days.
Silicone punctal
Occludes for as long as the plug stays in place. Full-occlusion and flow-control designs are sold as separate models.
Hydrogel intracanalicular
FORM FIT uses its own material and fitting method, and its instructions cover sizing, placement and removal separately.
References: OASIS punctal occlusion resources · Lacrivera VeraC7 and Vera90 sheet
Read sizes the way the maker intends.
Size names differ from brand to brand. The fitting range, the plug's diameter and the drainage channel's diameter are three separate numbers.
FlexFit sizes by punctal opening
| Size | Fits an opening of |
|---|---|
| X-Small | 0.2 to 0.3 mm |
| Small | 0.3 to 0.5 mm |
| Medium | 0.6 to 0.8 mm |
| Large | 0.9 to 1.0 mm |
These ranges cover both FlexFit sterile preloaded and FlexFit nonsterile bulk. Lacrivera size chart.
EagleVision sizing
- Eagle Collagen: available in 0.2, 0.3 and 0.4 mm diameters, each 2 mm long
- EaglePlug TearFlow: size by the O.D. (outside diameter); the I.D. is the diameter of the drainage channel
- Each model has its own IFU covering who is a candidate, contraindications, sizing, insertion, follow-up visits and removal
Full model-by-model sizing is in the EagleVision product catalogue.
Confirm the plug count in each pack.
Quantities in the store are packs, not single plugs. Open a product to see the listing, then choose the exact size and pack.
| Product | What is in the pack |
|---|---|
| FlexFit sterile preloaded | 2 plugs per box |
| FlexFit nonsterile bulk | 20 plugs per box, as 10 pairs with inserters |
| OASIS 6405 | 0.5 mm, 40 plugs |
| OASIS 6405-A | 0.5 mm, 20 plugs |
| OASIS 6200V | 20 plugs: six 0.3 mm, eight 0.4 mm and six 0.5 mm |
References: Lacrivera FlexFit bulk listing · OASIS Vision catalog · Each maker's product sheets and IFUs
Coding the procedure.
Punctal closure with a plug is billed under CPT 68761, one unit per punctum. Check the current policy of each payer before filing. Reimbursement examples published in the past are dated and do not guarantee payment.
Record and confirm
- Medical necessity, treatment already tried and patient consent
- Which puncta were treated, plus plug brand, size and lot
- Aftercare instructions given
- How each payer handles right and left eye modifiers, more than one procedure on a date, plugs placed again and a separate E/M visit
- Medicare usually bundles the plug itself into the procedure payment
Shop every plug in one place.
Browse the punctal plug category by brand, duration, size and occlusion type, and compare pack sizes before you order.
For licensed eye care professionals, as a product reference only. Choosing the patient, sizing the plug and placing it all follow the maker's instructions for use and the judgment of the treating provider. Coding notes are general; check them against current payer policy with your billing staff.