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Strabismus surgery, as described by CPT® Code 67332, is a specialized surgical procedure performed on patients who exhibit scarring of the extraocular muscles. This scarring may result from prior ocular injuries, previous strabismus surgeries, or retinal detachment surgeries. Additionally, it can occur in patients with restrictive myopathy, such as dysthyroid ophthalmopathy. The presence of scar tissue complicates the surgical approach, making the procedure technically more challenging. During the surgery, an incision is made in the conjunctiva, which is the thin membrane covering the eye, to access the affected extraocular muscle. The surgeon then carefully exposes the muscle insertion site, where scar tissue and adhesions are meticulously released. Any old suture material may also be removed as necessary to facilitate the procedure. Following this preparatory work, the surgeon performs the primary strabismus procedure, which may involve recession, resection, or other corrective techniques. It is important to note that this code is used in conjunction with the primary procedure code, as it is reported separately to account for the additional complexity involved in operating on a patient with such prior ocular conditions.
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The indications for performing strabismus surgery under CPT® Code 67332 include the following conditions:
The procedure for strabismus surgery under CPT® Code 67332 involves several critical steps:
Post-procedure care for patients undergoing strabismus surgery with CPT® Code 67332 typically includes monitoring for any complications, managing pain, and ensuring proper healing of the surgical site. Patients may be advised to follow up with their ophthalmologist to assess the alignment of the eyes and the overall success of the surgery. Additionally, instructions regarding activity restrictions and the use of prescribed medications, such as antibiotics or anti-inflammatory drugs, will be provided to support recovery and minimize the risk of infection.
| Short Descr | REREVISE EYE MUSCLES ADD-ON | Medium Descr | STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY | Long Descr | Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P4E - Eye procedure - other | MUE | 1 | CCS Clinical Classification | 21 - Other extraocular muscle and orbit therapeutic procedures |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 67311 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Strabismus surgery, recession or resection procedure; 1 horizontal muscle | 67312 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Strabismus surgery, recession or resection procedure; 2 horizontal muscles | 67314 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) | 67316 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) | 67318 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Strabismus surgery, any procedure, superior oblique muscle | 67335 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery) | 67340 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure) |
| RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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