Ophthalmology and Optometry Coding Alert

Question: My ophthalmologist noted a "slipped muscle" in his strabismus surgery documentation. What does this mean and does this require a special code?

New York Subscriber

Answer: Detached muscles, also referred to as "slipped" or "lost" muscles, are a common side effect of strabismus surgery.

The CPT code that best describes the repair of a detached muscle is +67340 (Strabismus surgery involving exploration and/or repair of detached extraocular muscle[s]), but properly identifying the circumstances that merit the use of 67340 isn't as straightforward.

Don't use 67340 for just any repair of extraocular muscles. When an extraocular muscle becomes detached during strabismus surgery, it must be recovered a procedure that requires dissection of tissues in the area. Because of the complexity of the procedure, using 67340 signals the payer to factor in the additional operative work. Even if the ophthalmologist is unable to pull up the detached muscle, his exploration does meet the requirements for using 67430.

67340 is an add-on code, meaning it must be listed in addition to a primary code, determined from the operative report, which will come from the strabismus code range 67311-67318.