Upper Eyelid Blepharoplasty and Blepharoptosis Repair

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
October 3rd, 2016

The Centers for Medicare & Medicaid Services (CMS) payment policy does not allow separate payment for a blepharoplasty procedure (CPT codes 1582215823) in addition to a blepharoptosis procedure (CPT codes 67901-67908) ontheipsilateral upper eyelid. Any removal of upper eyelid skin in the context of an upper eyelid blepharoptosis surgery is considered apart of the blepharoptosis surgery.

A blepharoplasty cannot be billed to Medicare and the beneficiary cannot be separately charged for a cosmetic procedure regardless of the amount of upper eyelid skin that is removed on a patient receiving a blepharoptosis repair because removal of any amount of upper eyelid skin is part of the blepharoptosis repair. In addition, the following are not permitted:

References:

Upper Eyelid Blepharoplasty and Blepharoptosis Repair. (2016, October 3). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/upper-eyelid-blepharoplasty-and-blepharoptosis-repair-31586.html

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