CPT code 67320 is for revision of eye muscle surgery, typically as an additional procedure.
CPT code 67320 is designated for surgical procedures involving the revision of eye muscle(s) as an add-on. This code is used specifically when additional eye muscle revision is required during the same surgical session as the primary procedure. It is important to note that this code should only be used in conjunction with the primary eye muscle surgery codes, and cannot be billed separately.
For CPT code 67320, which pertains to the revision of eye muscle(s) as an add-on procedure, several modifiers may be applicable depending on the specific circumstances of the surgery and billing context. Here is an ordered list of common modifiers that might be used with this code and the reasons for each:
1. -51 Multiple Procedures: This modifier is used when multiple procedures are performed during the same surgical session. It indicates that this procedure is secondary or additional to the primary procedure.
2. -59 Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. This can be crucial for procedures that are normally bundled but are performed in different contexts or anatomical sites.
3. -76 Repeat Procedure by Same Physician: This modifier is used if the same physician needs to repeat a procedure on the same day or during the same session. It helps in distinguishing between a repeated procedure and an ongoing or initial procedure.
4. -77 Repeat Procedure by Another Physician: Similar to -76, but used when a different physician performs the repeat procedure. This can occur in scenarios where multiple specialists are involved in a patient's care during a single visit.
5. -78 Return to the Operating Room for a Related Procedure During the Postoperative Period: This modifier is used when a patient must return to the operating room for a procedure related to the initial procedure during the recovery period. It is important for documenting and billing purposes, especially for complications or adjustments.
6. -79 Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a new or different procedure is performed by the same physician during the postoperative period of the first procedure, which is not related to the initial procedure.
7. -80 Assistant Surgeon: Used when an assistant surgeon is present during the procedure. This modifier helps in billing for the assistant surgeon's services.
8. -81 Minimum Assistant Surgeon: This modifier is used when minimal assistance is provided by another surgeon. It is less commonly used but applicable in specific scenarios where minimal assistance is required.
9. -82 Assistant Surgeon (when qualified resident surgeon not available): This modifier is used specifically when an assistant surgeon is necessary because a qualified resident is not available to assist.
10. -AS Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: This modifier is used specifically for billing purposes when a non-physician practitioner assists in surgery.
Each of these modifiers provides specific information that helps in the accurate documentation, coding, and billing of surgical procedures, ensuring that all aspects of the procedure are appropriately accounted for in the healthcare provider's revenue cycle management.
CPT code 67320, which pertains to the revision of eye muscle(s) as an add-on procedure, is generally reimbursable by Medicare when it is medically necessary and properly documented. The reimbursement for this code, however, can vary based on geographic location and the specific Medicare administrative contractor (MAC) policies.
To determine the exact reimbursement amount for CPT code 67320, it is advisable to consult the Medicare Physician Fee Schedule (MPFS) available on the Centers for Medicare & Medicaid Services (CMS) website or contact your local MAC. This will provide the most accurate and up-to-date information regarding reimbursement rates for your specific area.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and identifying underpayments with precision down to the CPT code level, including specific codes like 67320 for revising eye muscle(s) add-on procedures. Schedule a demo today to see how RevFind can help you secure correct payments from each individual payer and safeguard your financial health.
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