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Ophthalmology and Optometry Coding Alert

Diabetic Complications:

250.00 Alone Won't Cut It for Diabetic Patients With Ophthalmic Manifestations

Published on Mon Jan 09, 2012

Hint: Make sure to code the specific diabetic Dx your ophthalmologist is providing care for.If you're feeling hesitant about filing claims for patients with ophthalmic complications from diabetes, arm yourself with diagnosis basics and an understanding of manifestations to sail through diabetic patient coding.1. Master Decimal Places for DxOne of the most common mistakes coders make when filling a claim on a diabetic patient is reporting 250.00 (Diabetes mellitus without mention of complication) for the diagnosis. Code 250.00 alone generally is not sufficient to indicate the diagnosis of patients with diabetes. Instead, you must specify the exact type of diabetes for which the ophthalmologist is providing care.Why? Medicare and other third-party payers require a highly specific diagnosis to justify payment. That means that you must pay attention to the fourth and fifth places beyond the decimal point, which indicate any complications and the exact type of disease.Fourth place: The fourth [...]
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