Tag Archives: blepharoplasty

Eye Surgery Coding Challenge: Denials for 15823 & 67904

Posted on 04. Nov, 2009 by .

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Question: I started receiving denials for 15823 and 67904. To report this combo, should I use a modifier?

Answer: If the ophthalmologist performs the blepharoplasty (bleph) with excessive weight (15823, Blepharoplasty, upper eyelid; with excessive skin weighting down lid) on one eye and the blepharoptosis (ptosis) repair (67904, Repair of blepharoptosis; [tarso] levator resection or advancement, external approach) on the other eye, you may be able to report both codes by using modifier 59 (Distinct procedural service) on 15823 to designate a separate site from 67904. Otherwise, you should report only 67904.

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Avoid This Blepharoplasty Coding Blunder

Posted on 29. Mar, 2009 by .

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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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