tci Outpatient Facility Coding Alert - 2018 Issue 2

Reader Question: Cosmetic Blepharoplasty Or Not? Find Out

Question: What ICD-10 codes will show that the patient's blepharo­plasty wasn't cosmetic? Ohio Subscriber Answer: This answer depends upon your payer's guidelines. However, in general, most payers want to see documentation of a medical problem that makes the procedure necessary. Since Medicare doesn't cover any cosmetic procedures, the documentation and ICD-10 codes show the payer the patient's procedure was for medical reasons. There are dozens of possible ICD-10 codes that payers cite as possible diagnosis codes. They are as follows: C44.112 (Basal cell carcinoma of skin of right eyelid, including canthus) D04.12 (Carcinoma in situ of...

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