Make the Treatment of Ocular Allergies a Practice Profit Center

Ocular allergies affect millions of Americans—and you can treat their symptoms. Here’s how to code and bill correctly to make this service a profit center in your practice.

The bad news is that ocular allergies affect a large percentage of your patient population. The good news is that ocular allergies affect a large percentage of your patient population.

Allergic conjunctivitis is an ocular disease that optometrists can diagnose and treat. The best news about this condition is that you do not have to invest in any expensive instrumentation besides your slit lamp to care for these patients. In addition, these patients are loyal to your practice because you are alleviating their allergy symptoms and will continue to return every year because allergic conjunctivitis is typically a chronic condition that returns year after year.

Beyond providing care, here is what you (and your staff) need to know about coding and billing for this treatment.    

Diagnosis codes for allergic ocular disease includes the following:
370.32  Limbal and corneal involvement in vernal conjunctivitis
372.05  Acute atopic conjunctivitis
372.13  Vernal conjunctivitis
372.14  Chronic allergic conjunctivitis
373.32  Dermatitis of eyelid, contact and allergic

All of these diagnosis codes are acceptable billing codes for External Ocular Photography 92285 which has an average Medicare allowable of $23 and is a bilateral procedure.  External ocular photography is billable when it is used to measure the progress or deterioration of ocular tissue associated with ocular allergic disease. 

Two Major Categories of Allergic Conjunctivitis

Allergic conjunctivitis is divided into two major categories: seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC). SAC and PAC are triggered by an immune reaction involving a sensitized individual and an allergen. Ideally, if an individual can pinpoint what they are allergic to and avoid it then their symptoms will be minimal. However, if they are experiencing ocular symptoms they may need the care of their optometrist.

Typical symptoms include:
      •    Watery eyes
      •    Itchiness
      •    Sensitivity to light
      •    Redness
      •    Grittiness
      •    Eyelid swelling

The main difference between SAC and PAC is the timing of the symptoms
Patients with SAC experience symptoms for a short period of time. They may be bothered in the spring by tree pollen, in the summer by grass pollen, or in the fall by weed pollen. Generally, their symptoms resolve during other times of the year, especially in the winter. Patients with PAC experience symptoms throughout the year. Instead of outdoor allergens, they have problems with indoor allergens, such as dust mites and pet dander. Seasonal outdoor allergens may worsen their complaints if they are sensitive to them as well.

If a patient presents with allergic conjunctivitis you should attempt to determine whether it is seasonal or perennial to better decide how often you need to see the patient. A good history of previous episodes or evaluating current symptoms will help you decide.

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One thought on “Make the Treatment of Ocular Allergies a Practice Profit Center

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