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diabetes code for Opthamology clinic

K

kumeena

True Blue
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610
Location
Bellerose, NY
Primary care physician send a DM uncontrolled patient to Opth for evaluation (retinopathy).
Everything is Ok.patient does not have a retinopathy or any other Opth issues.

Can a Opth code DM uncontrolled or he/she does not take care of the problem so he/should code DM unspec.

Thank you
 
I would use 250.0x as the primary diagnosis for diabetic screenings if I was the Ophthalmology office.

EDIT: 250.02 is what I would code it with.
 
Last edited:
kumeena said:
she/he is not managing the problem. How does the provider know it is DM controlled or not controlled
Click to expand...

Ophthalmologist codes according to the reason for the visit (or chief complaint).
That was the diabetes.
You can use the diabetes without ophthalmic manifestations dx code.
 
kumeena said:
she/he is not managing the problem. How does the provider know it is DM controlled or not controlled
Click to expand...

I may be wrong but i would say since the PCP sent this patient over with the dx of DM uncontrolled then it would be ok to code it as so. In our clinic we code 250.0* along with V71.89 since we suspect the patient to have some type of retinopathy. If we don't know whether or not it is controlled or uncontrolled we would use unspecified.
 
cpccoder2008 said:
I may be wrong but i would say since the PCP sent this patient over with the dx of DM uncontrolled then it would be ok to code it as so. In our clinic we code 250.0* along with V71.89 since we suspect the patient to have some type of retinopathy. If we don't know whether or not it is controlled or uncontrolled we would use unspecified.
Click to expand...

I think differently. Patient's glucose levels may be out of control but that doesn't mean it has affected his eyes. Maybe other organs but not necessarily the eyes too.
It's not a given that diabetic patients must develop eye complications.

I still say to code the DM w/out eye manifestations if there were none.
 
vpcats said:
I think differently. Patient's glucose levels may be out of control but that doesn't mean it has affected his eyes. Maybe other organs but not necessarily the eyes too.
It's not a given that diabetic patients must develop eye complications.

I still say to code the DM w/out eye manifestations if there were none.
Click to expand...

We don't use the DM code with eye manifestations, we code it as 250.0* and V71.89
If the PCP is the one reffering the patient they should know whether or not the diabetes is controlled/uncontrolled and our doctors would just document what the PCP has stated in the consult note. At our clinic the pcp is usually reffering them to us because they belive the patient may have some type of eye complications. In that case we use the V71.89 code along with the reason for the exam.
 
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