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Ophthalmology and Optometry Coding Alert

Reporting 378.21 for Pseudo-Strabismus? Read This First

Published on Tue Jan 03, 2006

Esotropia doesn't fully describe the condition--an eyelid code is a better bet

A child appears to have crossed eyes, but the ophthalmologist finds no misalignment. There's no "false esotropia" code in the strabismus ICD-9 codes (378.xx)--but there is a correct way to report this condition.

Physiological characteristics of a child's face can sometimes cause the eyes to appear crossed (esotropic) when the condition of strabismus is not actually present. In most of these cases, the correct code is 743.63 (Congenital anomalies of eyelids, lacrimal system, and orbit; other specified congenital anomalies of eyelid), says Christina Hollis, OCS, coder and surgery scheduler at Pediatric Ophthalmology Associates in Columbus, Ohio.

Don't use one of the esotropia diagnosis codes, such as 378.21 (Intermittent esotropia, monocular), when the patient has false esotropia. Bottom line: If the test does not confirm a condition, never use a diagnosis code that indicates that the condition is present.
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