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Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) is a specialized procedure aimed at addressing complications that arise from previous eye surgeries or injuries. This procedure is particularly relevant when extraocular muscles, which are responsible for eye movement, become detached. Such detachment can occur due to various reasons, including prior recession or resection surgeries, trauma to the face or eye, or complications during surgical interventions. The surgery begins with an incision in the conjunctiva, the thin membrane covering the eye, over the affected muscle. This step is crucial as it allows the surgeon to access the extraocular muscles directly. In many cases, the presence of scar tissue from earlier surgeries or injuries complicates the exploration process, necessitating careful dissection. The surgeon then explores the orbit, the bony cavity containing the eye, to locate the detached muscle. If the muscle is not retrievable, a transposition procedure may be necessary, which involves repositioning the muscle to restore function. If the muscle is found, it is meticulously examined to assess its viability for reattachment. In instances where reattachment is not feasible due to severe damage, a transposition procedure is performed instead. Conversely, if reattachment is possible, the muscle is debrided to remove any damaged tissue and then sutured back to its original insertion site or to a new location on the globe. Following the repair of the detached muscle, the primary strabismus procedure is completed, ensuring that the overall alignment and function of the eyes are addressed.
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The procedure of strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) is indicated for several specific conditions and circumstances, including:
The procedure for strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) consists of several critical steps, which are detailed as follows:
Post-procedure care following strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) typically includes monitoring for any complications, managing pain, and ensuring proper healing of the surgical site. Patients may be advised to avoid strenuous activities and follow specific instructions regarding eye care. Follow-up appointments are essential to assess the success of the surgery and to monitor the alignment and function of the eyes as they heal. Any additional interventions, such as further surgeries or therapies, may be determined based on the patient's recovery and the outcomes of the initial procedure.
| Short Descr | REVISE EYE MUSCLE ADD-ON | Medium Descr | STRABISMUS EXPL&/RPR DETACHED EXTROCULAR MUSC | Long Descr | Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | 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 | 2 | 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) |
| 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. | 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.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 1991-01-01 | Added | First appearance in code book in 1991. |
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