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Wiki Coding only the Chief Complaint

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fnk001

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I am working for an optometrist and they believe that you only have to report the chief complaint no matter what else the doctor my talk about. Is that true for optometry?

Chief complaint is routine eye exam, but the patient also brings up another issue and they treat it as dry eye, they will only list the ICD-9 code for the eye exam and not for the dry eye as well. Is that correct?

Thank you for assistance.

Felicia
 
HI,

Chief complaint is Reason for visit,

If there is No definitive diagnosis present than Chief complaint is Primary diagnosis, If we have a Diagnosis and this is related to Chief complaint than code only condition not for chief complaint.

Regards,
Balamurugan M, CPC,COC,CCS
 
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