Blepharoplasty:
15820-15823 FAQ: Taking the Slack Out of Bleph Coding Could Recoup $300
Published on Tue Jan 11, 2011
Show the procedure isn't cosmetic with proper Dx coding and documentation. Don't assume all eyelid procedures are cosmetic. You could be cheating your practice out of insurance reimbursement if the surgery is medically necessary. Ophthalmic surgeons who perform blepharoplasty know that most insurers, including Medicare carriers, are predisposed to denying payment, and to assuming the procedure is cosmetic. While that's true, be aware of four myths that are preventing ophthalmologists from claiming legitimate reimbursement for medically necessary blepharoplasty. Question 1: Are Blepharoplasty Procedures Always Cosmetic? Answer: It depends on the procedure and the patient's main complaint. Procedures to remove excess skin and fat from the eyelids are frequently done due to medical necessity -- but to support medical necessity and convince Medicare, you need to submit the correct codes and airtight documentation, says Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, Director, Best Practices-Network Operations at Mount Sinai Hospital in New [...]
