How To Use CPT Code 67900

CPT 67900 is a code used for the repair of brow ptosis, which can be performed using various approaches. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 67900 procedures.

1. What is CPT 67900?

CPT 67900 is a code used to describe the surgical repair of brow ptosis, a condition where the eyebrow droops due to muscle weakness or paralysis. This procedure can be performed for cosmetic reasons or to remove obstructions to a patient’s vision. The code covers different surgical approaches, including supraciliary, mid-forehead, or coronal.

2. 67900 CPT code description

The official description of CPT code 67900 is: “Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)”.

3. Procedure

The 67900 procedure involves the following steps:

1. The patient is prepped and anesthetized.
2. The provider makes an incision above the eyebrow, near the hairline, or in the middle of the forehead.
3. Dissection is performed to access the eyebrow area and locate the fibers of the frontalis muscle.
4. Excess skin is excised, and the skin is pulled to reposition the brow above the eye socket.
5. The incision is closed with sutures.

4. Qualifying circumstances

Patients eligible to receive CPT code 67900 services are those with brow ptosis that is either causing a cosmetic concern or obstructing their vision. To prove medical necessity, documentation must show that the ptosis, excess fat, or excess tissue is impairing the patient’s vision. This is typically determined through visual field tests, performed twice – once normally and once with the extra fat or tissue taped out of the way of the patient’s eyes to simulate surgery results. Most insurers require a 12 percent to 30 percent improvement between untaped and taped visual fields.

5. When to use CPT code 67900

It is appropriate to bill the 67900 CPT code when a patient requires surgical repair of brow ptosis due to muscle weakness or paralysis, and the procedure is deemed medically necessary or is performed for cosmetic reasons. The specific surgical approach used (supraciliary, mid-forehead, or coronal) should be documented in the patient’s medical record.

6. Documentation requirements

To support a claim for CPT 67900, the following information should be documented:

• Medical necessity for the procedure, including visual field test results showing impairment due to ptosis, excess fat, or excess tissue.
• Details of the surgical approach used (supraciliary, mid-forehead, or coronal).
• Preoperative and postoperative photographs, if applicable.
• Operative report, including a detailed description of the procedure performed.

7. Billing guidelines

When billing for CPT code 67900, it is essential to ensure that the procedure is medically necessary and supported by appropriate documentation. Insurers may require prior authorization or additional information to determine coverage. It is crucial to check with the payer for specific coverage details and requirements. If the procedure is performed for cosmetic reasons, the patient should be informed that they may be responsible for the cost.

8. Historical information

CPT 67900 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates to the code since its addition.

9. Similar codes to CPT 67900

Five similar codes to CPT 67900 and how they differ are:

• CPT 15824: Forehead rhytidectomy, which is a procedure to remove wrinkles from the forehead.
• CPT 67901: Repair of blepharoptosis, which involves the repair of drooping eyelids.
• CPT 67902: Repair of ectropion, which is a procedure to correct the outward turning of the eyelid.
• CPT 67903: Repair of entropion, which is a procedure to correct the inward turning of the eyelid.
• CPT 67904: Repair of canthal tendon, which involves the repair of the tendon that supports the eyelid.

10. Examples

Here are 10 detailed examples of CPT code 67900 procedures:

1. A patient with significant brow ptosis obstructing their vision undergoes a supraciliary approach brow lift.
2. A patient with cosmetic concerns due to brow ptosis has a mid-forehead approach brow lift.
3. A patient with a history of facial nerve palsy undergoes a coronal approach brow lift to correct brow ptosis.
4. A patient with brow ptosis and excess upper eyelid skin undergoes a combined supraciliary brow lift and upper eyelid blepharoplasty.
5. A patient with asymmetric brow ptosis undergoes a unilateral mid-forehead brow lift to achieve symmetry.
6. A patient with brow ptosis and a high hairline undergoes a coronal brow lift with hairline advancement.
7. A patient with brow ptosis and lateral hooding of the upper eyelids undergoes a temporal brow lift.
8. A patient with brow ptosis and a history of multiple previous surgeries undergoes a revision coronal brow lift.
9. A patient with brow ptosis and significant forehead wrinkles undergoes a combined mid-forehead brow lift and forehead rhytidectomy.
10. A patient with brow ptosis and a history of facial trauma undergoes a coronal brow lift with orbital rim reconstruction.