Ophthalmology and Optometry Coding Alert

Question: A primary-care physician instructed one of our patients to see an eye doctor annually because a drug therapy she takes can affect vision. Her vision insurance doesn't cover exams annually, so her primary physician told her that her medical insurance would cover due to the medication. What diagnosis should I report? We did not see her for the disease, so would that diagnosis be inappropriate? Illinois Subscriber Answer: To report a toxicity observation for a high-risk drug, you will use different codes for the baseline visit (before the patient starts the drug) and the followup visits to monitor the effects. For the baseline visit, report an evaluation and management code and use the ICD-9 code for the condition for which the patient will take the drug -- for example, 714.0 (Rheumatoid arthritis). If your patient had already started the medication prior to her first visit, code it as you would [...]