Ophthalmology and Optometry Coding Alert

Question: One of our doctors operated on a vertical muscle of the right eye. Later, he operated on a horizontal muscle of the same eye. Besides reporting 67311 for the second surgery, should I report 67332 even though the previous surgery was done on a different muscle of the same eye?

Pennsylvania Subscriber

Answer: You should report strabismus surgery on the eye where there had been previous strabismus surgery. Report 67311 (Strabismus surgery, recession or resection procedure; one horizontal muscle) and the add-on code +67332 (Strabismus surgery on patient with scarring of extraocular muscles [e.g., prior ocular injury, strabismus or retinal detachment surgery] or restrictive myopathy [e.g., dysthyroid ophthalmopathy]). CPT code +67331 (Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles) would not be accurate because the previous surgery did involve an extraocular muscle. Code 67311 does not require that the surgery be on the same muscle.