Blepharoplasty - JF Part B
Educational Resources
Blepharoplasty
General Documentation Requirements for Blepharoplasty, Blepharoptosis Repair, and Brow Ptosis Repair:
- Documented excessive upper/lower lid skin;
- Supporting pre-op photos;
- Signed clinical notes support a decrease in peripheral vision and/or upper field vision;
- Signed physician’s or non-physician practitioner recommendations
- Documented subjective patient complaints which justify functional surgery (vision, ptosis, etc.);
- Visual field studies/exams (when applicable).
Coverage Criteria
- Local Coverage Determination: Blepharoplasty, Eyelid Surgery, and Browlift (L36286)
- Local Coverage Article: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift (A57191)
Codes
Code | Description |
---|---|
15820 | Removal of excessive skin of lower eyelid |
15821 | Removal of excessive skin of lower eyelid and fat around eye |
15822 | Removal of excessive skin of upper eyelid |
15823 | Removal of excessive skin and fat of upper eyelid |
67900 | Repair of brow ptosis |
67901 | Repair of upper eyelid muscle to correct drooping or paralysis |
67902 | Repair of upper eyelid muscle to correct drooping or paralysis |
67903 | Shortening or advancement of upper eyelid muscle to correct drooping or paralysis, internal approach |
67904 | Shortening or advancement of upper eyelid muscle to correct drooping or paralysis, external approach |
67906 | Suspension of upper eyelid muscle to correct drooping or paralysis |
67908 | Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis |
The Prior Authorization for Certain Hospital Outpatient Department Part B Associated Codes List is in Appendix B of the CMS OPD Operational Guide.
Resources
- Prior Authorization for Certain Hospital Outpatient Department (OPD) Services (CMS)
- Federal Register
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