Ophthalmology and Optometry Coding Alert

Reader Question:

Blepharoplasty and Blepharoptosis

Question: Are blepharoplasty (15823) and repair of blepharoptosis (67908) bundled?

California Subscriber
 
Answer: CMS has left this decision up to local carriers. Some have established a local medical review policy (LMRP) that addresses such billing. These generally have criteria for preoperative workups that demonstrate that the patient has laxity in the muscle that requires revision. Those that have not established an LMRP will usually deny 15823 (Blepharoplasty, upper eyelid; with excessive skin weighting down lid), which they consider a bundle with 67908 (Repair of blepharoptosis; conjunctivo-tarso-Mullers muscle-levator resection [e.g., Fasanella-Servat type]). CMS allows local carriers to have bundles that do not exist in the national Correct Coding Initiative, which does not bundle 15823 and 67908.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Ophthalmology and Optometry Coding Alert

View All