Wiki Upper and Lower Blephs

[staranes]

We have a surgeon wanting to do upper and lower blephs- what is the practice to coding this properly as the lower is being deemed cosmetic and upper is then getting denied...we are planning on doing an ABN, and appealing with documentation of start and stop times separated out for the lowers and uppers in hopes to at least get the upper paid, but how to we go about getting compensation for the lower?

 

[fwnewbie]

If there's no medical reason for the lower blephs, they won't be covered no matter how you bill it.

 

[staranes]

I understand lower won't be covered but we are having the issue that surgeon wants to do both at the same time...anesthesia can only bill one CPT, is there a way to get our uppers paid as they are a covered service? ( any other way then once we get the denial to send an appeal with documentation showing time start and stop for the two procedures?)

 

[fwnewbie]

Sorry I misread the problem and I don't know how to solve it, but showing start/stop times would certainly help your cause.