One or two?

The numeric or tabular listing of diagnostic codes for disorders of the eye and adnexa in the ICD-9 book begins with 360.00 (disorders of the globe), and ends with 379.99 (unspecified disorders of the eye). Italicized notes and instructions throughout this section will help you determine which diagnostic codes are manifestations of another disease process and require two diagnostic codes for accurate coding. Manifestation codes are also highlighted in blue for quick reference.

Diabetes

As primary eyecare providers, we play a significant role in diagnosing and managing ocular manifestations of diabetes. We therefore need a thorough understanding of coding for diabetes and ocular disorders associated with the disease. On October 1, 2005, additional codes 362.03 through 362.07 were added to further specify diabetic retinopathy. You can start using these immediately when billing Medicare. The ICD-9 book provides detailed descriptions of proper notation for diabetes diagnostic codes, which can be found in the tabular listing starting with 250. Diabetic diagnosis codes must be specified to the fifth digit, indicating the type of diabetes and whether it's under control. The fourth digit indicates the manifestation.
 

Once you determine the appropriate fourth and fifth digit for the diabetic code, refer to the additional instructions within the tabular listing to guide you to the appropriate secondary ocular manifestation code.

Remember the mandatory multiple coding rule when recording ocular manifestations of systemic disease. The primary diagnostic code refers to the disease process and the secondary diagnostic code designates the manifesting disease process. Use the most up-to-date ICD-9-CM book (version 2006) not only as a reference for specific ICD-9 diagnostic codes, but also for valuable information for accurate and efficient coding.