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Ophthalmology and Optometry Coding Alert

READER QUESTIONS:

Differentiate 375.15 and 370.21 by Condition

Published on Fri Mar 13, 2009

Question: Can 375.15 and 370.21 be used interchangeably? When would one be the preferred diagnosis code as opposed to the other? New York Subscriber Answer: Both 375.15 and 370.21 are diagnosis codes relating to the cornea, so a detailed description of the patients confirmed symptoms from the physician is crucial for the selection of the proper code. ICD-9 code 375.15 (Tear film insufficiency, unspecified) is defined in the ICD-9-CM manual as eye dryness and irritation due to insufficient tear production, which may present in the form of dry eye syndrome. When identifying diagnoses that require 375.15, look for descriptions that indicate the patient does not yet have an identifiable condition of the cornea, e.g., corneal lesions, because this code should only be used when the patients cornea is unaffected. Use 375.15 when a patient presents with punctate keratitis and the physician indicates it is a result of dry eye syndrome. [...]
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