Ophthalmology and Optometry Coding Alert

Hint: Make sure your specific diabetic Dx matches the primary care physician's. If you're feeling hesitant about filing claims for patients with ophthalmic complications from diabetes, arm yourself with diagnosis basics and an understanding of manifestations to sail through diabetic patient coding. 1. Master Decimal Places for Dx One of the most common mistakes coders make when filling a claim on a diabetic patient is reporting 250.00 (Diabetes mellitus without mention of complication) for the diagnosis. "Code 250.00 alone generally is not sufficient to indicate the diagnosis of patients with diabetes," states the November 2004 issue of Optometry, the Journal of the American Optometric Association. Instead, you must specify the exact type of diabetes for which the ophthalmologist is providing care. Why? Medicare and other third-party payers require a highly specific diagnosis to justify payment. That means that you must pay attention to the fourth and fifth places beyond the [...]