Summary & Overview
CPT 67318: Superior Oblique Strabismus Surgery
CPT code 67318 denotes a targeted surgical procedure to strengthen and reposition the superior oblique extraocular muscle as part of strabismus management. Nationally, this code is used in ophthalmology and pediatric ophthalmology practices as well as in hospital outpatient departments and ambulatory surgical centers to address diplopia and ocular misalignment attributable to superior oblique weakness or palsy. The procedure has clinical importance because precise muscle adjustment can restore binocular alignment, reduce symptomatic double vision, and improve functional vision.
Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for CPT code 67318, typical sites of service, common modifiers and billing considerations (where provided), and an outline of related billing issues encountered in strabismus surgery coding. The publication summarizes benchmarks and reimbursement context where available and highlights policy or documentation points that commonly affect coverage and claim adjudication. It is intended as a national overview for coding professionals, billing managers, and clinicians seeking a clear summary of the code’s clinical intent and administrative implications.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 67318 describes a surgical procedure on the superior oblique extraocular muscle to strengthen and reposition the muscle, correcting ocular misalignment and abnormal eye movements caused by superior oblique dysfunction. This procedure is a form of strabismus surgery focused on the superior oblique muscle.
Service Type: Ophthalmic surgical procedure — strabismus surgery
Typical Site of Service: Hospital outpatient department or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or young adult with symptomatic superior oblique palsy or torsional diplopia who is referred to an ophthalmologist or pediatric ophthalmologist for surgical correction. The patient presents with vertical diplopia, head tilt to compensate, abnormal ocular motility on exam, and prism or patching has failed to provide adequate functional improvement. Preoperative workflow includes comprehensive ophthalmic examination, binocular vision assessment, ocular motility measurements, and informed consent. On the day of surgery the patient receives general anesthesia (commonly for pediatric cases) or monitored anesthesia care for cooperative adults. The surgeon performs 67318 to strengthen or reposition the superior oblique tendon/muscle (for example, tuck or advancement procedures) to correct torsion and vertical deviation. Postoperative workflow includes immediate recovery in the ambulatory surgery unit or hospital PACU, early ophthalmic assessment for alignment and motility, pain control, activity restrictions, and scheduled follow-up visits to assess alignment stability and need for additional prism, occlusion, or revision surgery. Typical site of service: outpatient ambulatory surgery center or hospital outpatient department; inpatient admission is uncommon but may occur for complex multi-muscle or syndromic cases.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |