Ophthalmology and Optometry Coding Alert
Strabismus Codes Are Unilateral
Question: Our ophthalmologist resected the lateral rectus muscles of both the patient’s eyes during a strabismus surgery and marked 67312 (Strabismus surgery, recession or resection procedure; 2 horizontal muscles) in the EHR, but our office manager said that was incorrect. Can you advise?
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Answer: The strabismus surgery CPT® codes (67311-67318) describe unilateral procedures, or procedures performed on one eye only. Although the surgeon resected two muscles, they were in different eyes, so 67312 is not correct. Instead, you should report 67311 (Strabismus surgery, recession or resection procedure; 1 horizontal muscle) bilaterally. Most Medicare carriers want you to report the entire session on one line with modifier 50 (Bilateral procedure) and a “1” in the units field.
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Strabismus Codes Are Unilateral
Question: Our ophthalmologist resected the lateral rectus muscles of both the patient’s eyes during a strabismus [...]
