Eyebrow and Eyelid Repair - MEDICAID - VIRGINIA

This Humana Medicaid (VA) policy covers brow lifts and specific eyelid repair procedures (reduction of overcorrection, correction of eyelid retraction, and repair of floppy eyelid syndrome) only when defined clinical criteria and documentation requirements are met (including specified photographs, measurements, prior medically necessary surgery when applicable, and failure of conservative therapy for FES). Procedures performed for indications other than those explicitly listed are considered cosmetic and not medically necessary and therefore not covered.

"Brow lift (brow ptosis repair, browpexy) (67900) for brow ptosis and/or laxity of the forehead muscles when the following criteria are met: One frontal (straight ahead) photograph documenting droop..."

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