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November 1991

Functional Is Distinct From Cosmetic-Reply

Author Affiliations

Salt Lake City, Utah

Arch Ophthalmol. 1991;109(11):1494. doi:10.1001/archopht.1991.01080110027012

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In Reply.  —I thank Dr Baratta for his suggestions and for listing the criteria for blepharoplasty that have been adopted by the Florida Medicare carrier. I agree with his opinion that communication and working with the insurance carrier are important. I believe that we also try to work closely with our insurance carriers. My staff and I correspond and converse with insurance carriers daily. This is the best way of attempting to obtain reimbursement for procedures that could be considered either functional or cosmetic.Unfortunately, I do not share Dr Baratta's Florida experience that reimbursement is consistent with, or even determined by, the preoperative studies performed. In the states where I have worked, we remain perplexed regarding insurance carrier's determinations on reimbursement. You state that "a patient can now be definitively counseled before surgery when the testing criteria have been properly recorded." Unfortunately, with present Medicare laws, I would caution

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