How To Use CPT Code 67901

CPT 67901 describes the repair of blepharoptosis using the frontalis muscle technique with a suture or other material. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 67901?

CPT 67901 can be used to describe the repair of blepharoptosis, which is the drooping of the upper eyelid. This procedure involves attaching the eyelid to the frontalis muscle in the forehead using a suture or donor tissue. The purpose of this repair is to improve the cosmetic appearance or remove any obstruction to the patient’s vision.

2. Official Description

The official description of CPT code 67901 is: ‘Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia).’ This code specifically refers to the use of the frontalis muscle technique and the use of a suture or other material to repair the drooping eyelid.

3. Procedure

1. The provider begins by preparing and anesthetizing the patient.
2. An incision is made in the upper eyelid and brow.
3. A suture is placed through the upper eyelid to hold it in place.
4. The provider transfers the movement of the upper lid to the frontalis muscle above the eyelid using a frontal muscle technique.
5. A sling or strap is created using a suture or banked fascia, which is threaded between the incisions.
6. The material is secured in place to achieve the desired eyelid height and contour.
7. The incision is closed in layers using sutures.

4. Qualifying circumstances

CPT 67901 is used for patients who have blepharoptosis, which is the drooping of the upper eyelid. The repair is performed to improve the patient’s cosmetic appearance or to remove any obstruction to their vision. The procedure involves the use of the frontalis muscle technique with a suture or other material, such as banked fascia.

5. When to use CPT code 67901

CPT code 67901 should be used when a provider performs the repair of blepharoptosis using the frontalis muscle technique with a suture or other material. This code is specifically for the repair of the upper eyelid and should not be used for other eyelid procedures or repairs.

6. Documentation requirements

To support a claim for CPT 67901, the provider must document the following information:

• Patient’s diagnosis of blepharoptosis
• Details of the procedure performed, including the use of the frontalis muscle technique and the type of material used (suture or other material)
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 67901, ensure that the procedure performed matches the description of the code. The repair should involve the frontalis muscle technique with a suture or other material. It is important to note that this procedure may be considered cosmetic by some insurers, so it is essential to document medical necessity. Check with the payer for specific coverage details and requirements.

8. Historical information

CPT 67901 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a repair of blepharoptosis using the frontalis muscle technique with a suture to improve their cosmetic appearance.
2. A provider performs a repair of blepharoptosis using the frontalis muscle technique with banked fascia to remove an obstruction to the patient’s vision.
3. A patient with drooping eyelids undergoes a repair using the frontalis muscle technique with a suture to enhance their overall facial appearance.
4. A provider performs a repair of blepharoptosis using the frontalis muscle technique with a suture to correct the patient’s impaired vision.
5. A patient undergoes a repair of blepharoptosis using the frontalis muscle technique with a suture to improve their self-confidence and quality of life.
6. A provider performs a repair of blepharoptosis using the frontalis muscle technique with banked fascia to address the patient’s functional impairment.
7. A patient with drooping eyelids undergoes a repair using the frontalis muscle technique with a suture to restore symmetry to their face.
8. A provider performs a repair of blepharoptosis using the frontalis muscle technique with a suture to alleviate the patient’s discomfort and improve their visual field.
9. A patient undergoes a repair of blepharoptosis using the frontalis muscle technique with banked fascia to correct their eyelid position and improve their overall facial aesthetics.
10. A provider performs a repair of blepharoptosis using the frontalis muscle technique with a suture to address the patient’s functional impairment and improve their quality of life.