Summary & Overview
CPT 67345: Extraocular Muscle Toxin Injection to Correct Eye Alignment
CPT code 67345 represents an extraocular muscle injection of a toxin to weaken muscle activity and correct abnormal eye alignment. This minimally invasive therapeutic procedure is an established option in ophthalmology for managing strabismus and select motility disorders. Nationally, CPT code 67345 is relevant for outpatient ophthalmology practices, ambulatory surgery centers, and hospital outpatient departments that provide ocular alignment procedures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and payer coverage considerations. The publication provides benchmarks on utilization and reimbursement patterns where available, notes common billing modifiers and coding considerations, and summarizes the clinical rationale for using toxin injections as an alternative or adjunct to strabismus surgery.
This resource is intended for clinicians, billing professionals, and policy analysts seeking a national-level summary of CPT code 67345, its clinical application, and the payer landscape that affects coverage and billing practices.
Billing Code Overview
CPT code 67345 describes an injection of a toxin into an extraocular muscle to weaken its action and help restore normal ocular alignment. This procedure targets overacting ocular muscles to treat strabismus or other disorders of eye alignment.
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Service type: Therapeutic ocular muscle injection
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Typical site of service: Ophthalmology clinic, ambulatory surgical center, or hospital outpatient setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or adult patient presenting with symptomatic strabismus (ocular misalignment) such as esotropia or exotropia causing diplopia, cosmetic concern, or impaired binocular vision. The ophthalmologist evaluates ocular motility, alignment measurements (cover/uncover, prism and alternate cover testing), and determines that temporary chemical weakening of an extraocular muscle is appropriate. The procedure 67345 (chemodenervation of an extraocular muscle with toxin) is performed in an outpatient ophthalmology clinic or ambulatory surgery center under topical anesthesia, local injection, or brief monitored anesthesia care depending on patient age and cooperation. The workflow includes informed consent, sterile preparation, targeted injection of botulinum toxin into the affected extraocular muscle, short post‑procedure observation for immediate complications (e.g., globe perforation, ptosis, transient diplopia), and scheduling follow‑up to assess alignment and need for repeat injection or surgical options.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Provider unavailable/Not a standard CMS modifier in common use | Data not typically used for reporting; included in raw list but not commonly applied to professional claim lines |