Ophthalmology and Optometry Coding Alert

Many carriers will accept the ICD-9 codes below as diagnoses that demonstrate the medical necessity for fundus photography. Check your carrier for any LMRPs or LCDs. 115.92 -- Histoplasmosis, unspecified, retinitis
130.2 -- Chorioretinitis due to toxoplasmosis
190.5 -- Malignant neoplasm of retina
190.6 -- Malignant neoplasm of choroid
224.5 -- Benign neoplasm of retina
224.6 -- Benign neoplasm of choroid
238.8 -- Neoplasm of uncertain behavior of other specified sites
238.9 -- Neoplasm of uncertain behavior; site unspecified
250.00 -- Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled
250.01 -- Diabetes mellitus without mention of complication, type I, not stated as uncontrolled
270.2 -- Other disturbances of aromatic amino-acid metabolism
360.20-360.24 -- Degenerative disorders of globe
360.50 -- Foreign body, magnetic, intraocular, unspecified
360.54-360.59 -- Foreign body, magnetic
360.64-360.69 -- Foreign body, nonmagnetic
361.xx -- Retinal detachments and defects
362.xx -- Other retinal disorders
363.xx -- Chorioretinal inflammation, scars and other disorders of choroid
365.xx -- Glaucoma
377.00-377.49 -- Disorders of optic nerve and visual pathways
379.00 -- Scleritis, unspecified
379.07 -- Posterior scleritis
379.09 -- Other scleritis
379.11 -- Scleral ectasia
V58.65 -- Long-term (current) use of steroids
V58.69 -- Long-term (current) use of other medications
V67.51 -- Follow-up examination following completed treatment with high-risk medications, not elsewhere classified