How To Use CPT Code 67903

CPT 67903 describes the repair of blepharoptosis, specifically the tightening of the levator muscle that controls eyelid movement. 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 67903?

CPT 67903 is used to describe the surgical repair of blepharoptosis, which is the drooping of the upper eyelid. This procedure involves tightening the levator muscle, which is responsible for retracting the upper eyelid. The purpose of this repair is to improve the cosmetic appearance of the eyelid or remove any obstruction that may be affecting the patient’s vision.

2. Official Description

The official description of CPT code 67903 is: ‘Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach.’

3. Procedure

1. The provider begins by preparing and anesthetizing the patient.
2. The provider then turns the eyelid inside out and makes an incision at the upper tarsus.
3. Next, the provider isolates the levator muscle and resects and shortens the tendon until the ptosis corrects.
4. The provider internally advances the levator aponeurosis to the tarsus until the eyelid margin reaches the correct position.
5. Finally, the provider closes the incision in layers using sutures.

4. Qualifying circumstances

CPT 67903 is performed when a patient has blepharoptosis, which is the drooping of the upper eyelid. The procedure is done to improve the patient’s cosmetic appearance or to remove any obstruction that may be affecting their vision. It is important to note that this procedure is typically done for medical reasons rather than cosmetic purposes, and the patient’s vision impairment must be documented to prove medical necessity.

5. When to use CPT code 67903

CPT code 67903 should be used when a provider performs the repair of blepharoptosis by tightening the levator muscle using an internal approach. This code is specifically for cases where the levator muscle is resected or advanced to correct the ptosis. It is important to note that if the provider uses an external approach through an eyelid incision, a different code should be used.

6. Documentation requirements

To support a claim for CPT code 67903, the provider must document the following information:

• The patient’s diagnosis of blepharoptosis
• The need for the repair procedure, including any vision impairment caused by the ptosis
• A detailed description of the procedure performed, including the specific technique used
• The date of the procedure
• The start and end time of the procedure
• Any complications or additional procedures performed
• The provider’s signature

7. Billing guidelines

When billing for CPT code 67903, it is important to ensure that the procedure was performed using the internal approach and that the levator muscle was resected or advanced. If the provider used an external approach, a different code should be used. It is also important to document the medical necessity of the procedure, specifically any vision impairment caused by the ptosis. Additionally, it is important to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT code 67903 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with blepharoptosis undergoes a repair procedure using the internal approach, specifically the levator resection technique.
2. A provider performs a blepharoptosis repair on a patient with vision impairment caused by the drooping of the upper eyelid.
3. A patient undergoes a blepharoptosis repair to improve the cosmetic appearance of their eyelid.
4. A provider performs a levator advancement procedure to correct the ptosis in a patient with blepharoptosis.
5. A patient with obstructed vision due to blepharoptosis undergoes a repair procedure using the internal approach.