SEP 22, 2021
Please clarify the current bundling policy or if these codes can be billed as separate procedures? Do we use 67903 or 67904 Ptosis and 15823 Blepharoplasty?
Question: Please clarify the current bundling policy or if these codes can be billed as separate procedures? Do we use 67903 or 67904 Ptosis and 15823 Blepharoplasty?
Answer: The codes are bundled in CCI.
The only time when unbundling is appropriate is when 15823 is on one eye and either 67903/67904 is performed on the other — which is quite rare.
If 67903/67904 meeting the payer's functional criteria but the 15823 does not — and is cosmetic, you can submit ptosis to the payer and blepharoplasty to the patient (not the payer).