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upper eyelid ptosis repair with Whitnall sling.

Eva Posted Tue 25th of June, 2013 16:39:52 PM

I can't find anything that specifically states Whitnall sling.
67902 or 67906 or am I completely off...
Thanks for your help.

SuperCoder Answered Thu 27th of June, 2013 04:21:18 AM

Hi,

Please provide me a broader description in order to correctly judge the scenario.

Thanks,

Eva Posted Thu 27th of June, 2013 13:12:10 PM

Ok, here is the description:
we dissected down to the tarsus and levator muscle using blunt-tipped
Stevens scissors. We then bluntly dissected superiorly to reveal Whitnall's
ligament. A Whitnall sling was performed using one 5-0 Vicryl passed through
through Whitnall's ligament, the levator palpebrae superioris and tarsus to
raise the left upper eyelid to a desired position. The position of the left
upper eyelid was checked and it appeared in good position with good lid contour.
Hemostasis was achieved throughout the case with bipolar cautery. The wound was
then closed with 6-0 plain gut suture in an interrupted fashion

SuperCoder Answered Fri 28th of June, 2013 03:39:55 AM

Many of the blepharoptosis repair codes (67901-67908, Repair of blepharoptosis ...) describe procedures that seem almost identical. There are key differences, however, that will help you choose the correct code for the procedure your ophthalmologist performed, experts say.

Frontalis Fixation With Fascial Sling

AKA: Frontalis suspension

Code: 67902 (... frontalis muscle technique with fascial sling [includes obtaining fascia])

Look for: This procedure is almost exactly the same as that for code 67901. The difference? The ophthalmologist uses a sling of fascia lata -- thin fibrous tissue from the thigh -- to suspend the drooping eyelid. He may also use irradiated fascia taken from cadavers. Only use 67902 if you confirm that the ophthalmologist used fascia lata tissue.

Don't miss: The description for 67902 states, "includes obtaining fascia." You shouldn't have a separate code -- for example, from the 20000 section of the CPT® code book -- for the harvesting of the fascia, which is included in the description and payment of the procedure

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Superior Rectus Sling

Code: 67906 (... superior rectus technique with fascial sling [includes obtaining fascia])

Look for: The ophthalmologist uses the superior rectus muscle, which is attached to the outside of the eyeball, to suspend the drooping eyelid. Note that like 67902, the description for this code tells you that obtaining the fascia is included -- do not code separately for that.

However: Don't expect to see too many of these. This procedure runs the risk of reducing the function of the superior rectus muscle, so ophthalmologists do not perform it often.

Go with 67902 as per the description.

Eva Posted Fri 28th of June, 2013 13:04:44 PM

Thank you very much for the detailed explanation.

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