Ophthalmology and Optometry Coding Alert

Question: What ICD-9 code should I report for a diagnosis of pseudostrabismus?

Arizona Subscriber

Answer: An ophthalmologist may document "pseudostrabismus" if a child appears to have crossed eyes but the ophthalmologist finds no misalignment. There's no "false esotropia" code in the ICD-9 strabismus section (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).

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