Blepharoplasty, Reconstructive Eyelid Surgery, and Brow Lift - (0045)

Cigna covers medically necessary blepharoplasty, blepharoptosis repair, brow lift, ectropion/entropion repair, eyelid retraction correction and combinations when done to treat functional impairment (cosmetic-only procedures are excluded). Coverage requires objective documentation—preoperative frontal (and lateral/full-face for combinations) photographs showing corneal light reflex/encroachment, visual field testing showing ≥20° or 30% superior field loss corrected by eyelid taping (photographic documentation substitutes for children ≤7), MRD1 ≤2.0 mm for adult ptosis where applicable, evidence of functional impairment and failure of conservative/medical management when required, and absence/management of contraindications (e.g., active eye disease, dry eyes, uncontrolled thyroid disease).

"Upper eyelid reconstructive blepharoplasty (CPT 15822, 15823) is considered medically necessary for ANY of the following indications when the associated criteria are met: blepharochalasis, dermatoc..."