AHA Coding Clinic® for HCPCS - 2016 Issue 2; For Your Information

CMS reporting guidance for upper eyelid blepharoplasty and blepharoptosis repair

CMS payment policy does not allow the reporting of a blepharoplasty procedure in addition to a blepharoptosis procedure on the ipsilateral upper eyelid, because any removal of upper eyelid skin in the context of an upper eyelid blepharoptosis surgery is considered part of the blepharoptosis surgery. CMS states that regardless of the amount of upper eyelid skin being removed on a patient receiving a blepharoptosis repair the removal is considered to be a part of the blepharoptosis repair. For additional information, go to: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3523CP.pdf. ...

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