Optometry Coding & Billing Alert

Reader Questions:

Signs, Symptoms and E Codes - Oh My!

Question: A patient who had been the "master of ceremonies" at a family fireworks display come into the office complaining of discomfort - some burning around the eyes and eyelids. We didn't find anything wrong with him. Which diagnosis code should we use?

South Carolina Subscriber

Answer: In this instance, you should code the patient's symptom. The Symptoms, Signs, and Ill-Defined Conditions section of ICD-9 (780-799), specifically the category for symptoms involving nervous and musculoskeletal systems, directs you to the Disorders of the Eye and Adnexa section (360-379). There, under the category Visual Disturbances (368), you will find subcategory Subjective Visual Disturbances, with code 368.13 listed as visual discomfort, which includes asthenopia, among others. You could also potentially use 379.91 (Pain in or around eye).
 
You should list the circumstance that brought this on, the fireworks in this case, using code E923.0 (Accident caused by explosive material; fireworks).

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