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eyelid blepharoplasty w/ removal of heavy skin weighing /transblepharoplasty

louise Posted Thu 14th of March, 2019 07:44:04 AM
Is it necessary to code 67904 w/15823 The right upper eyelid blepharoplasty incision. A strip of orbital orbicularis muscle was also removed. The same procedure was completed successfully on the opposite side.   Attention was then drawn to the right brow pexy portion of the surgery. Through this same orbicularis oculi incision, a suborbicularis oculi dissection was carried superiorly to the superolateral orbital rim and a 5-0 monocryl suture then passed in a horizontal mattress fashion incorporating a purchase of the uppercut edge of the orbicularis muscle and the periosteum of the superolateral orbital rim. This suture, when tightened in position, resulted in excellent support to the ptotic eyebrow fat pad and elevation of the brow tissues.  
SuperCoder Answered Fri 15th of March, 2019 04:34:13 AM

Hi Louise,

As per the above documentation the only code that is required for the above procedure will be CPT 15823. Feel free to ask for any further query.

NOTE: CMS payment policy does not allow separate payment for a medically necessary blepharoptosis procedure (CPT codes 67901-67908) and medically necessary blepharoplasty procedure (CPT codes 15822, 15823) on an ipsilateral upper eyelid...NCCI contains procedure to procedure (PTP) edits that bundle the blepharoplasty procedure CPT codes 15822-15823 into the blepharoptosis procedure CPT codes 67901-67908. A physician may bypass these edits (1) with an NCCI-associated modifier if the blepharoptosis procedure and the blepharoplasty procedure are performed on contralateral upper eyelids; or (2) with appropriate modifiers in accordance with Medicare policy if the blepharoplasty procedure is a cosmetic procedure.


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