Ophthalmology and Optometry Coding Alert

Question: Am I just overlooking the pseudo-strabismus diagnosis code or is there not one? We had a patient complaining of crossing of the eyes, but the diagnostic test didn't point to strabismus. What diagnosis code should I use? Nebraska Subscriber Answer: Not only are you correct in your observation that there is no diagnosis code for pseudo-strabismus but you will be hard-pressed to find a diagnosis code that truly captures this condition of false esotropia. Pseudo-strabismus, or false strabismus, is the appearance of crossed eyes in children when the condition of strabismus isn't actually present. This 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. Because there isn't a specific diagnosis code for this condition, when you submit the claim for the diagnostic test you will need to use a diagnosis code that best describes what is causing the child's eyes to appear crossed. In most cases, the correct code is 743.63 (Congenital anomalies of eyelids, lacrimal system, and orbit; other specified congenital anomalies of eyelid). Don't fall into the trap of using one of the esotropia diagnosis codes, e.g., 378.21 (Intermittent esotropia, monocular), because the patient is not really experiencing this condition. If the test doesn't confirm a condition, never use a diagnosis code that indicates that condition.