Home Health ICD-9/ICD-10 Alert

Ask the right questions to diagnose low vision.

OASIS strategies don't require documentation from the physician, says Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principal of Selman-Holman & Associates in Denton, TX. "If the patient or his family says he cannot see or is legally blind, then I think you can code for the diagnosis," she says. You're verifying this information with the physician when he signs the 485, she notes.

The University of Michigan Kellogg Eye Center defines low vision as "a level of vision that is 20/70 or worse and cannot be fully corrected with conventional glasses. ... Unlike a person who is blind, a person with low vision has some useful sight."

The National Institutes of Health explains low vision as follows: "Low vision means that even with regular glasses, contact lenses, medicine, or surgery, people find everyday tasks difficult to do. Reading the mail, shopping, cooking, seeing the TV, and writing can seem challenging."

"We as home health clinicians can assess this," says Selman-Holman.

Here are some questions to ask your patients during an assessment to determine whether they have low vision.

Do you have difficulty:

• Recognizing faces of friends and relatives?

• Doing things that require you to see well up close, such as reading, cooking, sewing, fixing things around the house, or picking out and matching the color of your clothes?

• Doing things at work or home because lights seem dimmer than they used to?

• Reading street and bus signs or the names of stores?