Wiki Blepharoplasty billing

[jackie@cprmedicalbilling.com]

Any advice on how to bill this procedure? Our office does not take pictures and the doctor is indicating blepharoplasty but also is stating eyelid repair? How would you code this?

Thanks for any input.
J

 

[weshelman]

We bill from the range 15820 to 15823, depending on lower lids or upper , and whether the procedure involves extensive herniated fat pad (lower) or excessive skin (upper). Diagnosis is in the 374 range, depending on doctor's notes.

 

[jackie@cprmedicalbilling.com]

We bill from the range 15820 to 15823, depending on lower lids or upper , and whether the procedure involves extensive herniated fat pad (lower) or excessive skin (upper). Diagnosis is in the 374 range, depending on doctor's notes.

I thought those codes (15820 to 15823) require photos and a visual field? We do not do those things. Can you tell me approximately the reimbursement?

 

[Jen Verlinda]

I thought those codes (15820 to 15823) require photos and a visual field? We do not do those things. Can you tell me approximately the reimbursement?

Our office always requires the visual fields to determine if the degree of loss meets medical necessity. Typically, we get pre-authorization from all payers prior to the procedure by using photo's and the visual field test results. When the opthomologist does this, he provides an interpretation showing the result of lids taped vs. untaped. Medicare does allow these if the degree is severe enought. Lower lids are never considered medically necessary. Our office bills for physician and ASC:
15823 LT
15823 RT
15823 SG LT
15823 SG RT

Hope this helps.

Jen Verlinda, CPC
Account Manager
Pacific Dermatology & Cosmetic Center