NOV 06, 2019
Terminated Ptosis Repair Billing
Question: Our surgeon was performing ptosis surgery of the right eye, when the eyelid tissue proved to be too thin and fragile. The tissue superficial to the Wright needle and fascia tore, leaving the needle/fascia complex exposed. It was decided that proceeding further with the ptosis surgery was not possible under these circumstances. Instead, the torn eyelid tissue laceration was repaired with multiple deep 6-0 plain gut sutures and superficial 6-0 vicryl sutures.
Should we bill for both 67901 Repair of blepharoptosis; frontalis muscle technique with suture or other material and 67930 Suture of recent wound, eyelid, involving lid margin, tarsus and/or palpebral conjunctiva direct closure; partial thickness?
Answer: Submit either 67901 -53 -RT or 67930 -RT only, not both. The code 67930 has a lower allowable, as it only has a 10-day global period. Rather than submitting a discontinued surgery that takes weeks to review, submit what you were able to accomplish, rather than what you could not.
Should you submit 67901 -53 -RT, you may have to submit an operative report that reflects the work performed before surgery was terminated. Payment would be proportionate to the work completed. This may take six to eight additional weeks.