Ophthalmology and Optometry Coding Alert

Diagnosis of a medical problem helps prove that eyelid procedure wasn't cosmetic.Each carrier may have its own LCD outlining which diagnoses and documentation are needed to support medical necessity for blepharoplasty procedures 15822 (Blepharoplasty, upper eyelid) or 15823 (... with excessive skin weighting down lid). But if one of these ICD-9 codes that carriers often consider medically necessary legitimately describes your patient's condition, you're a long way toward demonstrating the eyelid surgery wasn't for cosmetic reasons. .373.4 -- Infective dermatitis of eyelid of types resulting in deformity373.5 -- Other infective dermatitis of eyelid373.6 -- Parasitic infestation of eyelid374.30-374.34 -- Ptosis of eyelids374.89 -- Other disorders of eyelid743.61 -- Congenital ptosis of eyelid743.62 -- Congenital deformities of eyelids743.63 -- Other specified congenital anomalies of eyelidV52.2  Fitting and adjustment of artificial eye.Note: Be sure to check with individual insurers for any LCDs they might have for 15822 or 15823.