NOV 15, 2016
Appropriate Modifier for Blepharoplasty
Question: We are submitting CPT code 15823 Blepharoplasty. However, it seems like there are multiple ways to submit. How should we submit to Medicare Part B and what would they reimburse?
Answer: When submitting to Medicare Part B and billing unilaterally, submit with -RT or -LT. However, if billing bilaterally, submit one line:
15823 -50, 1 unit and double the amount.
Payment will be 150 percent as the second procedure is reduced by 50 percent.
Other payers may prefer two lines with either the eye modifiers or the eyelid modifiers. Be sure to check your payer’s guidelines; they are not all the same.