Optometry Coding & Billing Alert

Reader Questions:

Severity of Retinopathy Drives Diagnosis Choice

Question: A patient with nonproliferative diabetic retinopathy reports to the optometrist for a scanning laser glaucoma testing (SLGT). What is the proper diagnosis coding for this visit?

Arkansas Subscriber

Answer: It depends on the severity of the retinopathy. ICD-9 has several codes for the condition.

Do this: Check the doctor's encounter notes to see if you can find any more information on the type of retinopathy.

Then, choose one of the following diagnosis codes:

- 362.03 -- Nonproliferative diabetic retinopathy NOS

- 362.04 -- Mild nonproliferative diabetic retinopathy

- 362.05 -- Moderate nonproliferative diabetic retinopathy

- 362.06 -- Severe nonproliferative diabetic retinopathy.

Regardless of which diagnosis you choose, be sure to report 92135 (Scanning computerized ophthalmic diagnostic imaging with interpretation and report, unilateral) for the scanning.

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