arkolab
Contributor
Looking for some input on how to correctly code the diagnosis of Macular RPE Mottling of the macula. It seems currently when our providers are documenting and coding for this diagnosis it is being corresponded with diagnosis code H35.89- Other specified retinal disorders, however, wondering if the diagnosis code H35.54- Dystrophies primarily involving the retinal pigment epithelium would be a more appropriate diagnosis. I have looked into this however I see alot of back and forth for these both being correct. When reaching out to our providers they had said that they personally never realized how many different conditions use the same ICD-10 code. When they type in the H35.89 and H35.54 there are many diagnoses options that come up for each. And what they see on our end is the “RPE mottling” not the “Other specified retinal disorders” but they see they both the H35.89 so it comes up differently on my end. Also, they had said that unfortunately any synonymous diagnosis to RPE mottling (atrophy of macula lutae, retinal macular atrophy, RPE atrophy) all fall under the same code. Even something like retinal tumor or vitreoretinal tuft shows up as H35.89. And they guess if there's no denials, they wouldn't see any reason to change, as the code we drop shows up in the problem list as it's coded, not as the generic "other specified retinal disorders".
