ASC Medicare Blepharoplasties being denied CPT® 15823

Has anyone had Medicare recouping payments for blepharoplasties/ 15823? We have not had this problem until recently. According to our LCD we are meeting the required documentation. Any insight would be great!!! Thanks again!

re: ASC Medicare Blepharoplasties being denied CPT® 15823

I have seen problems with blepharoplasties when there is not clear evidence that the procedure is cosmetic vs true vision obstruction. Did the physician submit before & after pictures plus a visual field graph? Are there supporting differences to meet medical necessity? If not, you will likely need to do so to support vision obstruction. Otherwise, Medicare will likely consider cosmetic.

re: ASC Medicare Blepharoplasties being denied CPT® 15823

Thank you for your response! We do submit the VF but we have not had to submit before/after pictures before, but maybe thats what we will have to start doing. Have a great day!