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Ophthalmology and Optometry Coding Alert

You Be the Coder:

Differentiate Reconstructive vs. Cosmetic Blepharoplasty

Published on Tue Feb 21, 2023

Question: Our ophthalmologist performed blepharoplasty on a patient with a drooping eyelid. We billed 15822, but the insurer denied the claim saying it was cosmetic. Can you explain how they make that determination, and whether we can appeal? North Carolina Subscriber Answer: You can always appeal if the physician believes the procedure was medically necessary, but first check the payer’s policy to [...]
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