Ophthalmology and Optometry Coding Alert

Long-term use of steroids or other common medications can have a dramatic effect on eye health, so identifying patients using them is essential and recent ICD-9 additions are going to make that identification easier.

Monitoring patients' drug-regimens and associating the use of certain medications with eye health issues is easier to code now that the addition of three new ICD-9 diagnosis codes have expanded V58.6 (Long-term [current] drug use).

The U.S. Department of Health and Human Services has released the following updates, establishing three new drug sub-categories for V58.6, which distinguishes them from their previous spot in the code's "other" category (V58.69, Long-term (current) use of other medications).  The following addition to the V-codes will help you track patient care with more precision:

 V58.63 Long-term (current) use of antiplatelet/antithrombotic
 V58.64 Long-term (current) use of nonsteroidal anti-inflammatories
 V58.65 Long-term (current) use of steroids. The codes might not have a high impact on the day-to-day life of your practice, but there are instances where they are valuable. Monitoring patients on steroids is important "considering that glaucoma or cataracts or even herpetic keratitis could be complications," says Donald Greenfield, MD, an ophthalmologist in Maplewood, N.J. 

"[A physician] could use such codes if the reason for the visit was to evaluate possible ocular side effects of these medications related to long-term use. For instance, steroids can predispose to glaucoma and cataract; nonsteroidals have been linked rarely to optic neuritis," says Michael Yaros, MD, an ophthalmologist in Runnemede, N.J.

The new codes go into effect Oct. 1.