Ophthalmology and Optometry Coding Alert

Question: How should I bill for a routine exam with the diagnosis post-keratoplasty in the right eye, and keratoconus in the left eye? What would the correct diagnosis codes be? Alabama Subscriber Answer: Report ICD-9 code 371.60 (Keratoconus, unspecified), 371.61 (Keratoconus, stable condition) or 371.62 (Keratoconus, acute hydrops) for the keratoconic left eye. To show the post-keratoplasty status in the right eye, report V42.5 (Organ or tissue replaced by transplant; cornea). Watch for: There is still some concern that payers will not reimburse for services linked to V codes. And there are few V codes that may be considered non-payable by Medicare. However, compliance with ICD-9 coding requires the physician to report the most appropriate code to describe the reason for the service. It is inappropriate to code an encounter for purposes of receiving payment. So, if the V code describes the most appropriate reason for the encounter, then that is [...]