Optometry Coding & Billing Alert
Find Diabetic Manifestation for Dx Code
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Question: What diagnosis code should we use when billing a diabetic patient who needs photos done? Would 250.00 work?
Kentucky Subscriber
Answer: ICD-9 code 250.00 (Diabetes mellitus without mention of complication; type II or unspecified type, not stated as uncontrolled) would not work.
Assuming the patient is visiting the optometrist because of ophthalmic manifestations of diabetes, you would report 250.5x (Diabetes with ophthalmic manifestations), with the fifth digit corresponding to whether the diabetes is type I, type II, controlled or uncontrolled.
For a secondary diagnosis, report whatever abnormality you are photographing--such as macular edema (362.07), glaucoma (365.44) or retinopathy (362.01-362.07).
If the retina is normal, there is nothing out of the ordinary to photograph. A photograph of an apparently normal eye is a routine picture and is not payable.
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