JUL 24, 2018
Billing for Removal and Reperformance of Tarsorrhaphy
Question: I have a young boy with CN 5, 6 and 7 palsies. He is coming to me for repair of his strabismus with medial rectus contracture secondary to longstanding esotropia from CN 6 palsy. He previously required a permanent lateral tarsorrhaphy for management of a neurotrophic corneal ulcer from CN 5 and 7 palsies. In order to perform the surgery, I plan to undo the tarsorrhaphy for adequate exposure to perform a medial rectus recession and superior and inferior rectus transpositions. I will then need to reperform the tarsorrhaphy. Would it be appropriate in this case to bill for a severing and performing a permanent lateral tarsorrhaphy in addition to my strabismus surgeries?
Answer: According to CCI edits, CPT code 67710 Severing of tarsorrhaphy is bundled into 67880 Construction of intermarginal adhesions, median tarsorrhaphy or canthorrhaphy. That said, not all payers follow CCI edits. Many commercial payers have their own set of edits. Verify edits with the commercial payer and, if not bundled, obtain preauthorization if required.
Learn more about surgeries in the Ophthalmic Coding: Learn to Code Pediatric and Strabismus.