Ophthalmology and Optometry Coding Alert

Question: If the physician performs transposition procedures on the right medial and right lateral rectus muscles during strabismus surgery, do you charge 67320 twice with modifier 59 for the second transposition?

Illinois Subscriber

Answer: You cannot report +67320 (Transposition procedure [e.g., for paretic extraocular muscle], any extraocular muscle [specify] [List separately in addition to code for primary procedure]) separately. This code is an add-on code, which means you must report it in addition to the code for the primary procedure.

In this case, because the ophthalmic surgeon operated on two horizontal muscles (the medial and lateral muscles) in the same eye, you would report 67312 (Strabismus surgery, recession or resection procedure; 2 horizontal muscles) as the primary procedure, and add +67320 for the transposition of the second muscle.