Wiki Frontalis Fixation with Levator Resection

[shaughnessy20]

Newby to Oculoplastic/Ophthalmology needing guidance please. I have a surgeon that did Levator Resection with Frontalis Fixation. They were asking for 67903, however it was not an internal approach. So I am looking at 67901 for the Frontalis Fixation and 67904 for the Levator Resection. I have never had this combination before. Any feedback would be greatly appreciated. Below is the OP note.

 

[natashalage]

hello, I am not an expert and still learning this specialty. I wish we had more participation from our experienced coders here. So, after reading the op note, I believe it's only 67904. it's like 67903 but external approach instead of internal. it's not 67901 because it will require a sling usage which we don't' have here.
67904-The levator tendon is isolated. The physician uses sutures to advance the levator tendon onto the tarsal plate in an adjustable fashion. The amount that the levator tendon is advanced corresponds to the degree of preoperative ptosis. the incision is repaired with sutures once the tendon has been secured in its new location.
67901-The physician makes an incision directly above the brow (supraciliary). The frontalis fixation technique is a mechanical suspension that transfers the movement of the upper lid to the frontalis muscle above the eyelid. Banked fascia from a cadaver donor or other material such as Mersilene mesh may be used to create a sling to the frontalis muscle.
67904 and 67901 are bundled where 67904 is the prim code; you will bill only 67904. However, 67903 is not bundled but it's not my choice of the cpt. Again, i am not an expert.

 

[shaughnessy20]

Thank you for your response, that was the same information I was finding. I went with 67904