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, but her primary physician told her that her medical insurance would cover the visits due to the use of high-risk medication. What diagnosis should I report? We did not see her for the disease for which she is taking the high-risk medications. Would that diagnosis be inappropriate?Illinois SubscriberAnswer: To report a toxicity observation office visit for use of a high-risk drug, you will use different diagnostic codes for the baseline visit (before the patient starts the drug) and for the follow-up visits to monitor the effects.For the baseline visit, report an evaluation and management CPT® 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 [...]