Optometry Coding & Billing Alert
Describe Follow-Up Visits Accurately With V Codes
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Question: If a patient receives treatment and the condition was resolved, which ICD-9 code should I report if the patient returns in six months for a follow-up visit? Answer: The most accurate way to code visits to follow up on treatment for a previous condition is to report a V code as the primary diagnosis, with the condition that the optometrist is following up on as the secondary diagnosis. You can find the follow-up V codes in the V67.x series in the ICD-9 manual. Although none specifically mention eye treatments, these are some examples of V codes that might be applicable: - Answers to Reader Questions and You Be the Expert contributed by David Gibson, OD, FAAO, practicing optometrist in Lubbock, Texas.
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Beware: Many payers won't accept a V code as a primary diagnosis that proves medical necessity. Some experts advise reporting the original diagnosis as the primary ICD-9 code, arguing that it best describes the reason the patient is being examined - if there were no original diagnosis, there would be no follow-up. Until the doctor pronounces the patient cured, the condition is till the reason for follow-up. Use the V-code as a secondary diagnosis, because it provides additional information for the office visit.
Best bet: Check with your payers for their policies on sequencing ICD-9 codes for follow-up visits. Your payer may interpret a follow-up visit as routine and thus not reimbursable.
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Describe Follow-Up Visits Accurately With V Codes
Question: If a patient receives treatment and the condition was resolved, which ICD-9 code should [...]