The procedure automatically involves the removal of redundant skin, so the second code applies when the patient has excessive redundant skin. Ms. Jones says one hallmark that indicates a need for CPT 15823 is a superior visual field defect, which should be indicated in the body of the operative report.
Every adoption agency is different and each has its own requirements for accepting or rejecting an adopting family. You need to know and understand these requirements and how they effect you and your ability to adopt a child.
It is safer to go with an agency study, even if a private social worker can to it, because if you adopt a child from another state, they may require an agency Home Study. In that scenario, you would need to begin again (losing time and money).