AHA Coding Clinic® for HCPCS - 2019 Issue 2; Ask the editor

Direct endoscopic browlift

A patient with bilateral visual field obstruction secondary to brow ptosis presented for a bilateral direct endoscopic brow lift. Vertical incisions were made at the level of the arch of each eyebrow and dissection was taken down to within 1 cm above the lateral orbital rims on both sides. The endoscope was introduced through one of the incisions and a dissector through the other. The periosteum was released over the nasal bones, and the arcus marginalis was released on each side out to the lateral orbital rim. Next, lateral cuts were made over the temporalis muscle down to the temporalis fascia. After utilizing the endoscope to identify the sentinel vein, further dissection was carried out prior to creating bone tunnels and suspending the brow on each side with a suture through the bone tunnel. Once the paramedian incisions where closed, the anterior portion of the temporoparietal fascial incision was sewed to the posterior portion to suspend the lateral brow. The procedure appears to utilize a combination of open and endoscopic techniques. What is the correct CPT code for a direct endoscopic brow lift? ...

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