Optometry Coding & Billing Alert

You Be the Expert:

Damaged Ducts

Question: I am having trouble finding the proper diagnosis code for this claim. The optometrist performs an intermediate ophthalmological exam for an established patient. The notes indicate that the patient’s lacrimal duct was damaged due to tear overproduction. Can you help me find an ICD-9 code for this claim? 

New Mexico Subscriber

Answer: The condition your doctor described in the notes is dacryops. According to ICD-9, the condition is defined as "Overproduction and constant flow of tears; may cause distended lacrimal duct."

On the claim, link ICD-9 code 375.11 (Dacryops) to 92012 (Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient).