tci Outpatient Facility Coding Alert - 2018 Issue 1

Reader Question: Consider this Strabismus Scenario

Question: The surgeon performed a resection procedure on two horizontal muscles for strabismus. We reported 67312, but our claim was denied. Can you help us? Colorado Subscriber Answer: In strabismus surgery, the ophthalmic surgeon shortens or lengthens the muscles surrounding the eye, which changes the alignment of one or both eyes. Confusion sometimes arises when the ophthalmic surgeon resects the lateral rectus muscles of both the patient's eyes. Because the ophthalmologist in this case performed a resection procedure on two horizontal muscles, 67312 (Strabismus surgery, recession or resection procedure; 2 horizontal muscles) may seem correct, but it is not...

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