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D Paikal, F Yu, AL Coleman; Patients With Uveitis Are Coded With Primary Open-angle Glaucoma In The 1999 Medicare Population . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3324.
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Purpose: The use of the primary open-angle glaucoma (POAG) code should be rare in patients with uveitis and glaucoma in the Medicare claim records because of the definition of POAG. This study evaluates whether patients with uveitis and glaucoma are coded with the code for uveitic glaucoma or with codes for uveitis and primary or non-specified open-angle glaucoma. Methods: Patients with an ICD-9 diagnosis of uveitis (codes available upon request) or uveitic glaucoma (365.62) were identified from a 5% sample of the 1999 Medicare database. The frequencies of a diagnosis of concurrent POAG (365.11) or non-specified open-angle glaucoma (365.10, 365.15) in those diagnosed with uveitis were determined. Also, the frequencies of argon laser trabeculoplasty (ALT) (CPT code 65855) and trabeculectomy (CPT codes 66170, 66172) were calculated in three groups of patients: those diagnosed with uveitic glaucoma, those with concurrent diagnoses of uveitis and POAG (POAG/uveitis), and those with concurrent diagnoses of uveitis and non-specified open-angle glaucoma (OAG2/uveitis). Results: In 1999, 315 patients had a diagnosis of uveitic glaucoma. 1367 (18.5%) of the 7396 patients with uveitis were diagnosed with POAG/uveitis, and 455 (6.15%) were diagnosed with OAG2/uveitis. The percentages of ALT and trabeculectomy in the 3 patient groups are as follows: Percentages of ALT and Trabeculectomy Among 3 Different Glaucoma Diagnoses View OriginalDownload SlideView OriginalDownload Slide *p-values derived from chi-square testing Conclusion: The concurrent use of the code for POAG and OAG2 with uveitis was more common than the use of the code for uveitic glaucoma. In addition, patients coded with uveitic glaucoma were less likely to have ALT, which is not usually recommended in uveitis patients, than patients coded with POAG/uveitis or OAG2/uveitis. The findings from this study may reflect a lack of knowledge in the community about the availability of a specific code for uveitic glaucoma. In addition, those individuals who use the code for uveitic glaucoma may be more knowledgeable about the recommended treatment of uveitis patients than those who use codes for POAG/uveitis and OAG2/uveitis.
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