Wiki Billing blepharoplasty

[cerowe]

We need clarification on when should my physicians use code 15823 vs 67904. Thank you,

 

[wbrodsky]

Always Code to the Highest Level of Specificity

It all depends on how the blepharoplasty is performed. The first code, 15823, may be considered a simple repair, or possibly an intermediate repair. The second code, 67904, sounds like that would fall under the complex repair. You can find more info on what defines these repairs in your CPT 2015 book, under the subsection of Repair(Closure) within the Integumentary System of the Surgery section.

Also modifier 59 could come into play if there is more going on than just a blepharoptosis. I would look in detail at the procedures actually performed and compare them to the "repair" details I had mentioned and also considering the modifier 59 to see if it would apply so you can code to the highest level

Best of luck!

 

[acalce]

I believe 15823 is only used when there is removal of the fat pad of the upper lid, and only if the fat pad obstructs the visual field.