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E-Newsletter • March 2026 |
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Editor's E-Note
Reimbursement can be a challenge, especially when one condition or symptom overlaps with another. One such condition, Sjogren’s disease is the focus of this month’s exclusive. To reduce denials, it is essential to make sure the coding for this condition is precise.
In addition to reading our e-newsletter, be sure to visit For The Record’s website at www.fortherecordmag.com. We welcome your feedback at edit@gvpub.com. Follow For The Record on Facebook and X, formerly known as Twitter, too.
— Dave Yeager, editor |
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Unraveling the Web of Sjogren’s Disease
By Barbara A. Rubin MEd, RHIA, CHIP
One of the marketing points to replace ICD-9-CM, with ICD-10-CM, was that ICD-9 was running out of space to add diseases and conditions or even expand related additional digits to a current code. Sjogren’s disease and dry eye are one of those examples. They are two separate conditions and should not be classified as one condition. However, old habits are truly hard to break.
It became common knowledge, even to patients, that “dry eye,” which is not a standalone condition or disease but is a symptom of Sjogren’s, was placed in the same category. The result was all conditions, whether they were dry eye or more complex like Sjogren’s, became known simply as dry eye syndrome and hence fell under the dry eye symptom, not the more crucial disease of Sjogren’s.
This created many issues in regard to being in compliance with coding assignment guidelines. It was not addressed until 2017, when the Sjogren’s Foundation and their advocates took up the campaign to correctly separate those two conditions and educate people: Dry eye is no more than a symptom of Sjogren’s, and the crucial debilitating disease was truly Sjogren’s disease, which is a systemic, cyclic, devastating disease. Four years later, after overcoming many challenges, the Sjogren’s Foundation was finally awarded their request for Sjogren’s disease to be separated from one of its symptoms and recognized as a serious debilitating disease.
Following the public’s being made aware of this victory for change and compliance, the Social Security Administration (SSA) Department for Disability realized the devastating, incapacitating impact of Sjogren’s disease and recognized this condition as permanently debilitating and incurable; it is now on SSA’s application list as being a permanent disabling condition.
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