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The CPT® Code 67335 refers to the placement of adjustable sutures during strabismus surgery, which is a procedure aimed at correcting misalignment of the eyes. Strabismus, commonly known as crossed eyes or wall eyes, occurs when the eyes do not properly align with each other when looking at an object. The use of adjustable sutures is a specialized technique that allows for postoperative adjustments to be made to the tension of the sutures, thereby enabling fine-tuning of the eye alignment after the initial surgical procedure. This technique is particularly beneficial as it provides the surgeon with the ability to assess the alignment of the eyes shortly after surgery and make necessary adjustments to achieve optimal positioning. The adjustable sutures are placed in conjunction with a primary strabismus surgery, which may involve recession or resection of the extraocular muscles. The procedure is designed to enhance the effectiveness of the surgery by allowing for real-time modifications to the muscle tension, ensuring that the desired alignment is achieved before finalizing the sutures with permanent knots. This approach not only increases the technical complexity of the surgery but also improves the overall outcomes for patients undergoing strabismus correction.
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The placement of adjustable sutures during strabismus surgery, as described by CPT® Code 67335, is indicated for patients who require correction of eye misalignment. The specific indications for this procedure include:
The procedure for placing adjustable sutures during strabismus surgery involves several critical steps, which are detailed as follows:
After the placement of adjustable sutures during strabismus surgery, patients typically undergo a period of monitoring to assess the alignment of the eyes. Postoperative care may include the application of prescribed eye drops to manage discomfort and prevent infection. Patients are usually advised to follow up with their surgeon for further evaluations to ensure that the eye alignment remains stable and to determine if any additional adjustments are necessary. Recovery times can vary, but patients are generally expected to experience improvements in eye alignment within a few hours to days following the procedure. It is important for patients to adhere to any postoperative instructions provided by their healthcare provider to facilitate optimal healing and outcomes.
| Short Descr | EYE SUTURE DURING SURGERY | Medium Descr | PLACEMENT ADJUSTABLE SUTURE STRABISMUS | Long Descr | 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) | 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 | 67320 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure) | 67331 | Add-on Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) | 67332 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article 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) | 67334 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure) |
| 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). | LT | Left side (used to identify procedures performed on the left side of the body) | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 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.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | CR | Catastrophe/disaster related | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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