How To Use CPT Code 67312

CPT 67312 describes a surgical procedure used to correct strabismus, a condition in which the eyes are misaligned and point in different directions. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 67312?

CPT 67312 is a code used to describe a surgical procedure performed to realign the eye muscles in order to correct strabismus. The physician may either perform a recession (weakening) or resection (strengthening) of the muscles to improve the patient’s vision.

2. Official Description

The official description of CPT code 67312 is: ‘Strabismus surgery, recession or resection procedure; 2 horizontal muscles.’

3. Procedure

1. After administering anesthesia, the physician makes an incision either into the fornix or in the limbal area of the eye.
2. A recession of the medial rectus muscle is performed, and the muscle surrounding the Tenon’s capsule is dissected.
3. Scissors and forceps are used to cut the subconjunctival areolar tissue to expose the muscle.
4. A blunt hook or forceps is used to elevate the muscle (lateral or medial) for traction.
5. Sutures are placed into the muscles and clamped before removing the muscles.

4. Qualifying circumstances

CPT 67312 is used for patients with strabismus, a condition in which the eyes are misaligned and point in different directions. The procedure involves the recession or resection of two horizontal muscles, typically the lateral rectus (LR) and medial rectus (MR) muscles. The specific muscles worked on may vary depending on the patient’s condition and the physician’s assessment.

5. When to use CPT code 67312

CPT code 67312 should be used when a surgical procedure is performed to correct strabismus by recession or resection of two horizontal muscles. It is important to accurately document the specific muscles worked on and the approach used during the procedure.

6. Documentation requirements

To support a claim for CPT code 67312, the following documentation is required:

• Patient’s diagnosis of strabismus
• Details of the surgical procedure performed, including the specific muscles recessed or resected
• Approach used during the procedure (e.g., incision in the fornix or limbal area)
• Date of the procedure
• Any additional relevant information or complications encountered during the surgery
• Signature of the performing physician

7. Billing guidelines

When billing for CPT code 67312, ensure that the procedure performed involves the recession or resection of two horizontal muscles for the correction of strabismus. It is important to accurately document the details of the procedure and any additional relevant information. Consider any specific billing guidelines provided by the payer or coding guidelines to ensure accurate reimbursement.

8. Historical information

CPT code 67312 was added to the Current Procedural Terminology system on January 1, 1990. It underwent a code change on January 1, 2009, with the description updated to specify the recession or resection procedure on two horizontal muscles.

9. Examples

1. A patient undergoes strabismus surgery, and the physician performs a recession procedure on the lateral rectus and medial rectus muscles.
2. During a strabismus repair, the physician performs a resection procedure on the lateral rectus and medial rectus muscles to correct the patient’s misaligned eyes.
3. A child with strabismus undergoes surgery, and the physician performs a recession procedure on the medial rectus muscles of both eyes.
4. A patient with exotropia undergoes strabismus surgery, and the physician performs a resection procedure on the lateral rectus muscles to align the eyes.
5. During a strabismus repair, the physician performs a recession procedure on the medial rectus muscles and a resection procedure on the lateral rectus muscles to correct the patient’s eye misalignment.