Optometry Coding & Billing Alert
If It's Not Relevant to Encounter, Leave Chronic Condition Dx off Claim
Question: A patient with type II diabetes reported to the optometrist for an exam. The patient was also complaining of a headache and neck pain. Should we include a diagnosis code for diabetes on this claim, or should we just code for the symptoms that the patient lists for this visit? Answer: It depends on the situation. Diabetes is a chronic condition, and you should only report ICD-9 codes for chronic conditions when they are relevant to the service the physician provides. But if the diabetes does not affect the optometrist's treatment options or is otherwise not addressed during the encounter, you should report only 784.0 and 723.1 as diagnoses.
Missouri Subscriber
If the optometrist considers the diabetes during the patient's course of treatment, you should attach the following ICD-9 codes to your procedure code(s):
- 784.0 (Headache) to represent the patient's headache.
- 723.1 (Cervicalgia) to represent the patient's neck pain.
- 250.00 (Diabetes mellitus without mention of complication; type II or unspecified type, not stated as uncontrolled) to represent the diabetes.
Optometry Coding & Billing Alert
- Defend Your Patients' PHI With Shredders
Put shredder where it will be used most
If an identity thief nabs some of a [...] - Focus on LT, RT and TC Modifiers for A-Scans
Watch out for inconsistencies among your carriers
A-scans are some of the most common procedures performed [...] - Clip and Save:
Simplify Your Place-of-Service Coding With This List
Fingertip guide to 5 POS codes eliminates confusion
Choosing the correct place-of-service (POS) code for your [...] - READER QUESTIONS:
Don't Count on Cash for Education
Question: Is there a way we can offset the cost of educational materials, pamphlets, etc., [...] - READER QUESTIONS:
Satisfy Consult Criteria With a Fax
Question: To use a consultation code, a coworker thinks we should make sure the requesting [...] - READER QUESTIONS:
Educate Staff Before E-Mailing Patients
Question: Our physician wants the office to begin using e-mail to contact our patients. Can [...] - READER QUESTIONS:
Strengthen Your Denial Management Efforts
Question: Are there any tips you can offer on how to handle denials? It seems [...] - READER QUESTIONS:
Keep 'Pharm' Hands Off Patient Info
Question: Our medical office has had problems with -phishing- scams on our Web site. Today, [...] - READER QUESTIONS:
Head Off Copay Problems With Proactive Phone Work
Question: We are in the midst of a copayment crisis. In the past month, we [...] - READER QUESTIONS:
If It's Not Relevant to Encounter, Leave Chronic Condition Dx off Claim
Question: A patient with type II diabetes reported to the optometrist for an exam. The [...] - You Be the Expert:
Modifiers and Incident-To Services
Question: Should I use a modifier when reporting services provided incident-to the optometrist's care?
Utah Subscriber
Answer: [...]
