CMS removes lid surgery code from HOPD prior authorization list 

CMS removed a type of corrective lid surgery from the hospital outpatient department prior authorization list Jan. 7. 

The removal comes after a yearlong effort from the American Academy of Ophthalmology and American Society of Ophthalmic Plastic and Reconstructive Surgery to "revise problematic definitions that caused confusion and denials," according to a Jan. 5 news release. Prior authorization, which requires providers to obtain approval from payers before conducting the procedure, is a huge roadblock for many ophthalmologists. 

CMS made other updates, including continuing to allow physicians to obtain authorizations on behalf of facilities, extending the exemption cycle and including an option to opt out of the exemption process for providers, and revising the title of the blepharoplasty service category. 

Read more about the CMS changes here

 

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