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Posted By Amanda on 02-22-2002, 17:46:00 in Ophthalmology
I was looking in the ICD-9 book under V42.5 and there is a blue box by it
stating Secondary Diagnosis. The beginning of the section right about it
states Persons with Condition Influencing their health. Note: These
categories are intended for the use when these conditions are recorded as
"diagnoses" or "problems."

Can someone help me understand what all of that means.

Can it be the primary dx for a patient coming in for a 1 month post op after
a corneal transplant? Not our patient & wasn't suppose to be a co-mgmt.

Thanks!

Amanda
Comments (5)
Posted By michael on 02-24-2002, 19:38:00

In a message dated 2/22/02 3:51:22 PM, akunze@eyeearclinic.com writes:

<< Thanks! Both answers have been so helpful!!!


Amanda

>>

V45.6 may be useful as a secondary Dx to indicate that prior eye surgery
occurred when the procedure code requires it.

Such as 66172 trab with antimetabolite
65772 AK
mod 58 with staged procedure or 2nd greater than 1st
67331, 67332, 67340, 67343

I wonder whether it might be a primary Dx in cases where the prior surgery
constitutes a chronic condition that is the medical reason for the visit...

Dr. Yaros

Posted By Amanda on 02-22-2002, 19:54:00
Thanks! Both answers have been so helpful!!!

Amanda
Posted By Amanda on 02-22-2002, 19:52:00
Thanks!
Posted By douglas on 02-22-2002, 19:38:00
Sorry, in my answer a moment ago, I was focused on the blue box part of the
question, and missed the opportunity to use your particular patient as an
example. The reason for the visit is post-op care (V67.0) which does not
have a blue box and can be a primary diagnosis, and the V42.5 is explanatory
of what type of surgery, but not a primary diagnosis. I gave an example
where the secondary diagnosis status after corneal transplant complicating
the management decision for a patient with cataract. Thanks to Angela for
completing the answer. Might V45.69 also be an option for a secondary
diagnosis in this patient (also a "blue box" code)?

Douglas R. Anderson

Posted By douglas on 02-22-2002, 19:25:00
Well, I'm not absolutely sure, but I have understood it this way. Such a
diagnosis would never be the primary reason for an office visit or other
service. However it may impact on a management decision. Hence the person
is about to have a cataract extraction, cataract is the main visual problem,
and the nature of the surgery is impacted by the fact that the patient had a
previous corneal transplant, so is (optionally) listed as an additional
diagnosis. If documented in the record, a compulsive coder would include
previous corneal transplant in the list of diagnoses for the patient. This
is helpful if the coding data is used to generate statistics - - "we did
600 cataract extractions last year, of whom 42 had previous corneal
transplants". However, if the only purpose of coding is go generate a
claim, then there may be little reason to list more than the single
diagnosis that forms the basis for performing the service being billed.

Douglas R. Anderson

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