Wiki Billing 92250 with and E/M

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jojogi

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If a patient diabetic retinopathy comes in for their annual eye exam and the doctors performs and E/M visit, can we link the V72.0 or V82.0 to the 92250 and the diabetes code to the E/M visit? I am new to this so any advice would be appreciated. :) Thanks
 
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Pretty sure the diabetes would be the primary DX for both, followed by the diabetic retinopathy. The guidlines state "when assigning codes for diabetes and its associated conditions, the code(s) from cateory 250 must be sequenced before the codes for the associated conditions" In laymans terms, this simply means the code for the retinopathy is a manifestation code, therefore it is listed secondary to the diabetes.
 
I agree with Heidi; I would use the diabetes and the retinopathy codes on the photos and exam both. I would not think V72.0 would get you payment from any payer. For the exam, since you are coding it as E/M, I assume it's an annual *diabetic* eye exam, meaning the intention is to monitor the patient's eye health in regards to their diabetes, and not just to get a glasses update? If that is the case, I wouldn't have V72.0 on the claim at all, unless maybe you are billing a refraction and there's no refractive error.
 
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