Marianne Posted Tue 21st of May, 2013 15:34:22 PM
I have a surgeon that notes in the Op Note:
Postoperative DX: Exotropia with a history of previous eye muscle surgery.
BODY: A lid speculum was placed between the lids of the left eye. Conjunctival changes were noted nasally and temporally from the previous eye muscle surgery....but nowhere else does he mention "scarring of extraocular muscle" as noted in the code descriptor for +67332. I know for a fact he is using +67332 with the main strabismus procedure code. From what I have learned I dont feel he has justified using the add on code just for conjunctival changes. I feel +67332 is for extra time encurred when the muscles are scarred and he needs to spend extra time reducing the scar tissue. Do you feel "conjunctival changes" justifies the use of the addditional coding of +67332? Thanks in advance.
SuperCoder Answered Wed 22nd of May, 2013 11:00:39 AM
Good point raised. I am working on it and will respond soon.
Marianne Posted Tue 28th of May, 2013 15:52:17 PM
did you find anything out yet?
SuperCoder Answered Tue 28th of May, 2013 16:07:28 PM
67332 Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy)
Code 67332 is also an add-on procedure. However, the eyes being operated on have scarring of extraocular muscles or restrictive myopathy. (ie, 67332 describes the enhanced work [preoperative, intraoperative] necessary in patients undergoing surgery who have had pervious eye muscle surgery, or who have severe abnormalities of the extraocular muscles).
In your case everything is leading towards 67332 except a very proper documentation.There has been a history of previous eye muscle surgery.
Try to talk to the physician about this and inform about the lack of documentation. Scarring is a buzz word here for 67332. In absence of it, I will also not support using the code.