A CALL FOR SPECIFIC CODES FOR DIABETES FOOT AND EYE CARE

In this report, we propose new International Classification of Disease s (ICD) codes that could be incorporated into computer-based patient r ecords or administrative data to monitor and improve diabetes care. Ne ither the ICD, 9th Revision, nor its imminent replacement, the ICD, 10 th Revision, has specific codes for foot examinations and funduscopic examinations in the asymptomatic person, high-risk diabetic foot statu s, or clinically significant macular edema. Adoption of official codes for these procedures and conditions implemented in conjunction with c omputerized databases could be used for surveillance, program planning , and quality of care assessment. Computerized medical records could u se the codes to monitor care and issue reminders to patients and provi ders. Payers could offer reimbursement incentives to encourage complia nce with standard recommendations. These codes for care procedures cou ld be linked to outcomes, such as amputations and blindness, to improv e our understanding of the etiology of blindness and the relationship between process and outcome. The uniform adoption of these codes would facilitate comparison between health care systems, geographic regions , and nations. The diabetes community should encourage the National Ce nter for Health Statistics to adopt new codes that could be used to mo nitor diabetes preventive care practices.