Avoid This Blepharoplasty Coding Blunder
Posted on 29. Mar, 2009 by Editor in Coder's Cranium
Don’t settle for denials for a functional surgery that a payer incorrectly assumes is cosmetic, warn American Academy of Ophthalmology coders Sue Vicchrilli & Kim Ross.
Code 15823 (Blepharoplasty, upper eyelid; with excessive skin weighing down lid) can describe a medical necessary procedure to correct a visual complaint. However, payers might deny the claim as cosmetic if the documentation doesn’t note that the saggy eyelids are impairing vision, write Vicchrilli and Ross in a recent issue of the AAPC’s Coding Edge.
Watch out if the chart states simply something like “Patient complains of excessive baggy upper lid skin.”
April 2 AUDIO: Master Cataract Co-Management Billing and Coding.
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