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Posted By Amanda on 07-27-2002, 16:21:00 in Ophthalmology
We saw a 3 month old per their PCP for possible decreased vision. The final
impression was developmental visual delay. Does anyone have a dx code that
would work for that?

Amanda
Comments (8)
Posted By douglas on 08-04-2002, 22:24:00
Agreed. I think the initial answer about 5 rounds back in the chain of
correspondence it was suggested to ask the ophthalmologist had concluded
that prominent epicanthal folds (which commonly accompany a broad base of
the nose) were the reason that someone thought the eyes were misaligned.

There is a genuine coding problem if there is intermittent esotropia
observed by the parents but not confirmed by the ophthalmologist, because
"strabismus suspect" won't do as a diagnosis. Also, does large angle kappa
have an ICD-9 code?

Do you use a V-code for suspected disease not found?

Doug Anderson
Posted By michael on 08-04-2002, 21:48:00
What I am trying to say is that the term pseudostrabismus includes ALL
abnormalities which might give the false appearance of strabismus. The most
common is epicanthal folds. However, wide bridge of the nose and large angle
kappa are also possibilities. In the original question, there was no mention
of epicanthal folds. Only that the exam was normal. One cannot presume
epicanthal folds without more info. In the CPT there is no code that
specifically states "pseudostrabismus." Therefore, one must code the cause.
In this example, it is also possible that there is no cause. The mother may
just be overly concerned because a sibling had strabismus. I wouldn't code
for epicanthal folds unless they are present.

Dr. Yaros

In a message dated 7/31/02 11:05:20 AM, danderson@med.miami.edu writes:

<< -- MsgId= 124805--

In the "Index of Diseases" in the front of the ICD-9 book, look up

epicanthus, epicanthal fold (congenital) (which is what causes

pseudostrabisus), you will indeed find 743.63 to be the correct code.

>>

Posted By michael on 08-04-2002, 21:36:00
That is the code for an eyelid abnormality, such as epicanthal folds. if the
mother thought the patient had strabismus, yet on exam there are no eyelid
abnormalities, such as epicanthal folds, I don't think you can logically bill
that code.

Dr. Yaros

In a message dated 7/31/02 10:44:49 AM, carolync@hillsboroeyeclinic.com
writes:

<< The code we use for pseudostrabismus is 743.63. Hope this helps you!!


Carolyn

Hillsboro Eye Clinic

>>

Posted By Amanda on 07-31-2002, 13:43:00
All of these answers are great but I had two separate scenerios. I'm
assuming that the answe isn't the same for both.???

Amanda

Posted By douglas on 07-31-2002, 13:11:00
In the "Index of Diseases" in the front of the ICD-9 book, look up
epicanthus, epicanthal fold (congenital) (which is what causes
pseudostrabisus), you will indeed find 743.63 to be the correct code.
Posted By Amanda on 07-31-2002, 00:54:00
thanks!
Posted By Amanda on 07-31-2002, 00:54:00
Sorry I forgot. Do you think you would use that dx for both situations?

Amanda
Posted By Amanda on 07-30-2002, 23:19:00
I still have the below situation and don't know what to do with it & now
another one.

We have another 3 yr old that was sent by their pcp because the mother had
noticed that the patient's left eye doesn't move quite right and the father
has a lazy eye. Also that the eyes seem somewhat crossed at times? After the
evaluation the doctor couldn't find anything wrong with the eyes other than
a slight refractive error.

What dx could I use on this one too?

Amanda
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