Optometry Coding & Billing Alert
Primary Diagnosis for 'Foggy Vision'
Question:
Maryland Subscriber
Answer: You should only report 368.8 (Other specified visual disturbances) as a primary diagnosis code when the optometrist doesn't find a more definitive diagnosis during the course of the visit.
Carriers often consider a visit for blurred vision the same thing as a routine exam -- and Medicare will not pay for this service.
Primary vs. secondary:
Whenever possible, you should list a more definitive diagnosis as primary and then the patient's complaint of blurred vision as secondary. For example, if the optometrist discovers that a cataract is causing the patient's blurry vision, you would first list 366.12 (Incipient cataract) and then 368.8. You should always strive to report the most descriptive and accurate ICD-9 codes possible. If a patient claims her only reason for the visit is a routine exam, experts recommend that the optometrist ask her a series of detailed questions to uncover any complaints she may have but doesn't think of right away. If she denies any blurriness of vision, the optometrist should ask, "Do your eyes ever itch, burn, or water?" This may lead you to report dry eye syndrome (375.15, Tear film insufficiency, unspecified) or allergic conjunctivitis (372.14, Other chronic allergic conjunctivitis).Do this:
Rather than ask if a patient's vision is blurry, ask if there is anything she can't see well enough to do anymore. Older patients sometimes expect a loss of vision and will not report something they think is "normal." The case history does not end until the patient leaves the office, so sometimes the true reason for the exam today is determined after the exam is completed.Optometry Coding & Billing Alert
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Primary Diagnosis for 'Foggy Vision'
Question: Many of our patients claim general reasons for their visit, such as "I can't [...]
