GUIDELINE NOTE 173, INTERVENTIONS THAT ARE …



CPT 15820-15821 Blepharoplasty, lower eyelidLast reviewed at VbBS in May 2018. Minutes indicate that the staff recommendation was accepted without significant discussion. HERC approved the recommendations without change. HERC staff recommendations:Add ICD-10 ICD-10 H02.83 (dermatochalasis) to line 469 Acquired ptosis and other eyelid disorders with vision impairment and remove from line 567 BLEPHARITISWill allow coverage of blepharoplasty when GN130 criteria are metFollows the ICD-10 Ophthalmology reviewer’s intentAdd line 351 Strabismus due to neurologic disorder to GN130Has indications for blepharoplastyAdd CPT 15820-15821 (Blepharoplasty, lower eyelid) to line 660 and add the following entry to GN173:GUIDELINE NOTE 173, INTERVENTIONS THAT ARE UNPROVEN, HAVE NO CLINICALLY IMPORTANT BENEFIT OR HAVE HARMS THAT OUTWEIGH BENEFITS FOR CERTAIN CONDITIONSThe following Interventions are prioritized on Line 660 CONDITIONS FOR WHICH CERTAIN INTERVENTIONS ARE UNPROVEN, HAVE NO CLINICALLY IMPORTANT BENEFIT OR HAVE HARMS THAT OUTWEIGH BENEFITS:Procedure CodeIntervention DescriptionRationaleLast Review15820-15821Blepharoplasty, lower eyelidNo clinically important benefitMay 2018 ................
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