Ophthalmology and Optometry Coding Alert

Check the Medicare fee schedule for important bilateral coding guidelines for 673xx. Coders -- especially those for pediatric ophthalmologists -- know how difficult sorting out the various eye muscles involved in strabismus surgery can be. With 12 ocular muscles to keep track of, one simple coding mistake could cost your practice hundreds, unless you know the ropes. Let Modifier 50 Spring You From 67312 Trap Scenario: An ophthalmologist removes a 6.5-mm section of the lateral rectus muscle of the patient's left eye and resects the muscle to strengthen it and correct strabismus. He then repeats the procedure on the right eye, again removing 6.5 mm of the lateral rectus muscle and then resects it. Two different codes may tempt you -- but only one will bring you the reimbursement you deserve. Be careful: Because the ophthalmologist performed a resection procedure on two horizontal muscles, 67312 (Strabismus surgery, recession or resection procedure; two horizontal [...]