Optometry Coding & Billing Alert

Published on Wed Apr 07, 2004 PDF

Question: We had a patient present with crossing of the eyes, but when the optometrist performed the diagnostic test for strabismus, the results were fine. Which diagnosis code should I report for this "false strabismus"?

Nevada Subscriber

Answer: You're having a hard time diagnosing this "pseudo-strabismus" because ICD-9-CM does not contain a code for the condition of false esotropia. 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).

Pseudo-strabismus, or false strabismus, is the appearance of crossed eyes in children when the condition of strabismus isn't actually present. The condition may occur from an extra fold of skin near the eye or even as a result of the size and shape of the infant's facial features. The condition is usually self-correcting as the child grows.

Don't fall into the trap of using one of the esotropia diagnosis codes, such as 378.21 (Intermittent esotropia, monocular), because the patient is not really experiencing this condition. If the test does not confirm a condition, never use a diagnosis code that indicates that the condition is present.