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Show Medical Necessity for Ptosis Repair
Published on Mon Aug 23, 2004
Although each carrier may have its own LMRP outlining which diagnoses support medical necessity for blepharoplasty and brow repair procedures, this list shows many of the ICD-9 codes typically accepted.
172.1 - Malignant melanoma of skin of eyelid, including canthus
173.1 - Other malignant melanoma of skin of eyelid, including canthus
190.1 - Malignant neoplasm of orbit
216.1 - Benign neoplasm of eyelid, including canthus
216.3 - Benign neoplasm of skin of other and unspecified parts of face
232.1 - Carcinoma in situ of eyelid, including canthus
333.81 - Blepharospasm
351.0 - Bell's palsy
351.9 - Facial nerve disorder, unspecified
368.40 - Visual field defect, unspecified
373.00-373.34 - Inflammation of eyelids
374.00-374.23 - Other disorders of eyelids
374.30 - Ptosis of eyelid, unspecified
374.31 - Paralytic ptosis
374.32 - Myogenic ptosis
374.33 - Mechanical ptosis
374.34 - Blepharochalasis
374.41 - Lid retraction or lag
374.43 - Abnormal innervation syndrome of eyelid
374.46 - Blepharophimosis
374.82-374.89 - Other disorders of eyelid
376.21 - Thyrotoxic exophthalmos
378.51 - Third or oculomotor nerve palsy, partial
378.52 - Third or oculomotor nerve palsy, total
701.8 - Other specified hypertrophic and atrophic conditions of skin
743.00 - Clinical anophthalmos, unspecified
743.61 - Congenital ptosis of eyelids
743.62 - Congenital deformities of eyelids
743.63 - Other specified congenital anomalies of eyelid
V45.78 - Acquired absence of organ, eye
V52.2 - Fitting and adjustment of artificial eye