tci Part B Insider - 2006 Issue 6

DERMATOLOGY: Keep Your Eyes Open For Medically Necessary Eyelid Procedures

Carriers will cover blepharplasty for functional or reconstructive surgeries Medicare is prone to deny payment to dermatologists who perform blepharoplasty because it assumes the procedure is cosmetic. But you can win payment if the procedure is medically necessary. Here’s how. Whether or not a blepharoplasty procedure is always cosmetic depends on the procedure and the patient’s main complaint. Procedures to remove excess skin and fat from the eyelids are frequently done out of medical necessity …quot; but to convince Medicare, you need the right codes and airtight documentation.Note: Insurers cover blepharoplasty procedures 15822 (Blepharoplasty, upper...

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