AHA Coding Clinic® for HCPCS - 2024 Issue 3; Ask the Editor

Blepharoptosis repair by Muller’s muscle-conjunctival resection (MMCR) technique

A patient with mechanical left upper eyelid ptosis presents for blepharoptosis repair by internal approach. Once the patient was prepped, a bridle suture was passed through skin, orbicularis and the tarsal plate of the mid position of the left upper eyelid, superior to the lash line. The left upper lid was everted over a Desmarres retractor, and the conjunctiva and Mueller’s muscle were distracted from the underlying levator muscle. Forceps were applied to the conjunctiva and Mueller’s muscle, after which a Putterman clamp was applied. Once the forceps were removed, a double-armed #6-0 plain suture was woven from medial to lateral beneath the clamp. A blade was utilized to excise the conjunctiva and Mueller’s muscle. Low power bipolar cauterization was utilized for hemostasis. The second arm of the suture was woven from medial to lateral, effecting an advancement of conjunctiva and Mueller’s muscle. Both suture ends were brought out through the subconjunctival space laterally. The suture was tightened, tied, and trimmed with the knot buried in the wound. The lid was re-everted to its natural anatomic position. Using the MMCR technique, the tarsus is preserved. What would be the correct code for the blepharoptosis repair using Muller’s muscle-conjunctival resection (MMCR) technique? ...

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