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please advise on coding

louise Posted Sat 30th of March, 2019 14:03:38 PM
Functional blepharoplasty, left upper lid. 2. Canthoplasty with horizontal lower lid tightening, right eye. 3. Conjunctivoplasty, right eye. 4. Excision of the abnormal skin of the lower lid with a flap closure, left lower lid. 5. Suture removal, right upper and lower eyelid------  left upper eyelid A standard lazy-S blepharoplasty incision was marked using the existing eyelid crease. The lid crease was marked at 8.0 mm from the central lash line. skin/muscle flap was excised with Bovie cautery. The wounds were irrigated and hemostasis was obtained with bipolar cautery. The orbital septum was opened horizontally. Preaponeurotic fat was exposed and removed in moderation. Medial orbital fat was exposed and removed with Bovie cautery. The fat was excised and the stump was cauterized with bipolar cautery prior to its release into the orbit. left lower lid /An eyelid margin suture was placed using 6-0 Vicryl suture. A lateral canthotomy incision was made with a #15C Bard-Parker blade. Using Kaye blepharoplasty scissors, a dissection plane was created between the orbicularis muscle and the orbital fat. A subciliary incision was made with the Kaye blepharoplasty scissors. Skin/muscle flap was dissected, exposing the orbital septum. The wound was irrigated and hemostasis was obtained with bipolar cautery. The orbital septum was opened. Starting with the medial fat compartment, the medial fat was prolapsed and then removed with Bovie cautery.   A lateral canthotomy and inferior cantholysis were performed. A 5 mm portion of the lower lid was excised in a full-thickness fashion. Hemostasis was obtained with Bovie cautery. Next, the excessive and chemotic conjunctiva was excised in a wide curvilinear fashion from the inferotemporal to inferomedial quadrant. The lateral tarsus was engaged using a double-armed 6-0 Vicryl suture in horizontal mattress fashion. The Prolene sutures were then passed through the remnant of the lateral canthal tendon and then externalized through the lateral portion of the upper lid blepharoplasty incision with periosteal fixation. The Prolene suture was tied with square knots and then cut. The lateral canthus was reinforced with interrupted 7-0 Vicryl suture.   Skin/muscle flap was pulled superolaterally. A lateral triangle was cut. The flap was secured to the periosteum using 4-0 silk suture. The lateral canthotomy wound was subsequently closed using interrupted 7-0 silk sutures. The superior flap was draped over the lid margin. Redundant skin was excised in a conservative fashion across the lower lid margin. A strip of orbicularis muscle was also excised. The subciliary incision was closed using a running 7-0 silk suture. This completed a combined canthoplasty, conjunctivoplasty and the excision of the abnormal lower lid skin with flap closure.   codes used 67950, 68320, 15822 67961    
SuperCoder Answered Mon 01st of April, 2019 04:41:23 AM


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