How To Use CPT Code 67331

CPT 67331 describes a specific procedure for strabismus surgery on a patient who has previously undergone eye surgery or suffered an eye injury that did not involve the extraocular muscles. This article will provide an overview of CPT code 67331, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 67331?

CPT 67331 is a code used to describe a particular surgical procedure known as strabismus surgery. This procedure is performed on patients who have previously undergone eye surgery or experienced an eye injury that did not involve the extraocular muscles. Strabismus surgery aims to correct an imbalance in the eye muscles that control the movement of the eyeball, ensuring that both eyes align properly.

2. Official Description

The official description of CPT code 67331 is: ‘Strabismus surgery on a patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to the code for the primary procedure).’ This code is considered an add-on procedure and should be reported in conjunction with the primary procedure code.

3. Procedure

1. During the strabismus surgery, the provider begins by making an incision in the conjunctiva at the junction of the sclera with the cornea.
2. They then identify the specific extraocular muscle that requires treatment.
3. If there is scar tissue or adhesions from a prior procedure, the provider will excise them.
4. Depending on the nature of the strabismus, the provider may perform recession or resection of the extraocular muscle.
5. Recession involves detaching the eye muscle and reattaching it farther back on the eye to weaken a stronger muscle.
6. Resection, on the other hand, involves removing a small part of the eye muscle and suturing it back together to strengthen it.
7. The provider will report CPT code 67331 in addition to the primary procedure code to reflect the additional work or increased level of difficulty involved in the strabismus surgery.

4. Qualifying circumstances

CPT code 67331 is used when the patient has previously undergone eye surgery or experienced an eye injury that did not involve the extraocular muscles. The surgery is performed to correct strabismus, a condition in which the eyes are misaligned and point in different directions. It is important to note that this code should only be used when the previous surgery or injury did not involve the extraocular muscles.

5. When to use CPT code 67331

CPT code 67331 should be used when performing strabismus surgery on a patient who has had a previous eye surgery or injury that did not involve the extraocular muscles. It is important to ensure that the surgery is specifically addressing the strabismus and not any other issues related to the previous surgery or injury. This code should be reported in addition to the primary procedure code.

6. Documentation requirements

To support a claim for CPT code 67331, the provider must document the following information:

• Details of the previous eye surgery or injury that did not involve the extraocular muscles
• Description of the strabismus surgery performed
• Specific extraocular muscle treated
• Any excision of scar tissue or adhesions
• Details of recession or resection performed
• Documentation of the primary procedure code

7. Billing guidelines

When billing for CPT code 67331, it is important to ensure that the surgery meets the qualifying circumstances described earlier. This code should be reported in addition to the primary procedure code. It is crucial to follow the specific guidelines provided by the payer regarding the use of this code and any associated modifiers. Additionally, it is important to accurately document the details of the surgery to support the billing claim.

8. Historical information

CPT code 67331 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient who previously underwent cataract surgery requires strabismus surgery to correct misalignment of the eyes.
2. An individual who suffered an eye injury in the past needs strabismus surgery to align their eyes properly.
3. A patient who had a prior retinal detachment surgery now requires strabismus surgery to address misalignment.
4. Someone who had undergone LASIK surgery in the past needs strabismus surgery to correct their eye alignment.
5. A patient who had a previous corneal transplant requires strabismus surgery to ensure proper eye alignment.
6. An individual who had an eye injury resulting from trauma needs strabismus surgery to correct the misalignment.
7. A patient who had undergone glaucoma surgery in the past requires strabismus surgery to address their eye misalignment.
8. Someone who had a previous refractive surgery now needs strabismus surgery to align their eyes properly.
9. A patient who had a prior vitrectomy surgery requires strabismus surgery to correct the misalignment of their eyes.
10. An individual who had undergone a previous eye muscle surgery needs strabismus surgery to ensure proper eye alignment.