Coding and Billing

ICD-10: Get Ready to Update Coding

By Maria Sampalis, OD

SYNOPSIS

The new ICD-10 codes now take effect October 2015. Train your staff (and yourself) with this primer and resource guide on new codes for common eye conditions.

ACTION POINTS

UNDERSTAND MAJOR CHANGES. ICD-10 adds more codes to replace the use of coding modifiers.
USE KEY FREE RESOURCE. Online resources, some of them free, help you transition to ICD-10.

GET STAFF ON BOARD. Devote 10-15 minutes per staff meeting to practicing coding in specific areas such as myopia, cataract, diabetic eye exams and glaucoma.

Converting to ICD-10 will provide more accurate coding and provide more detailed information on the condition such as severity and location in the eye. Here is a summary of this major change, along with examples of how this coding will be updated in several areas of your practice. ICD-10 will help ensure what you should be doing already–coding to the highest level of specificity.

The deadline to update from ICD-9 to ICD-10 coding has been extended by one year to October 2015. The conversion will expand 17,000 codes to over 140,000 codes! Use the extra time to prepare your practice for this new coding system.

ICD-10 Implementation Resources

CMS.GOV 

Sign up for ICD-10 updates:

http://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10

ICD Implementation Fact Sheet

http://www.cms.gov/Medicare/Coding/ICD10/Downloads/
ICD10_Introduction_060413[1].pdf

FROM CMS.GOV:

Access two free Medscape Education modules that provide guidance to small practices:

ICD-10: A Roadmap for Small Clinical Practices 

ICD-10: Small Practice Guide to a Smooth Transition Continuing medical education (CME) and continuing education (CE) credits are available to physicians and nurses who complete the learning modules.

ICD-9 to ICD-10 Free Conversion Staff Training Tool

You can use ICD10data.com/convert to help you transition, and it’s free!

You can use this online guide to conduct an introductory staff meeting on the ICD-10 change. Then, in each subsequent meeting, you can devote 10-15 minutes to address a different aspect of the practice. For instance, one meeting could focus on coding changes for myopia, while the next could address changes to cataract coding, and another could look at coding for diabetic retinopathy or glaucoma.

Major Change:

In ICD-10, more codes to choose from replaces the use of modifiers. The new system will take getting used to, but once you and your staff have adapted, coding should be faster and more efficient without the need to add modifiers.

In ICD-10, eye codes are a subcategory under H. And the category of the eye is separated by a series of numbers. For example, the lens is H25-H28, where glaucoma is H40-H42.

Click HERE for a free download with an overview of ICD-10 for the eye and the rest of the body, which you will need to understand for co-management.

Myopia

ICD-9

367.1
ICD-10
H52.1, but there is more. If you needed to code exactly which eye is affected, then H52.11 would be myopia for the right eye.

H52.10 myopia, unspecified eye
H52.11 myopia, right eye
H52.12 myopia, left eye
H52.13 myopia bilateral

Cataract

ICD-9

cortical cataract: 366.15
ICD-10

Cortical cataract: H25.01
Cortical age-related cataract

H25.011
Cortical age-related cataract, right eye

H25.012
Cortical age-related cataract, left eye

H25.013
Cortical age-related cataract, bilateral

H25.019
Cortical age-related cataract, unspecified eye

Diabetic Eye Exam

ICD-9

Combine: 250.50 Diabetes with ophthalmic manifestations, type II or unspecified type, not stated as uncontrolled
With: 362.04 Mild nonproliferation diabetic retinopathy
ICD-10

You would use E11.32- Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy

Glaucoma

ICD-9

365.00 Preglaucoma, unspecified

365.01 Open angle with borderline findings, low risk

365.02 Anatomical narrow angle borderline glaucoma

365.03 Steroid responders borderline glaucoma
ICD-10

H40 Glaucoma
H40.0 Glaucoma suspect
H40.00 Preglaucoma, unspecified
H40.001 …… right eye
H40.002 …… left eye
H40.003 …… bilateral
H40.009 …… unspecified eye
H40.01 Open angle with borderline findings, low risk
H40.011 …… right eye
H40.012 …… left eye
H40.013 …… bilateral
H40.019 …… unspecified eye
H40.02 Open angle with borderline findings, high risk
H40.021 …… right eye
H40.022 …… left eye
H40.023 …… bilateral
H40.029 …… unspecified eye
H40.03 Anatomical narrow angle
H40.031 …… right eye
H40.032 …… left eye
H40.033 …… bilateral
H40.039 …… unspecified eye
H40.04 Steroid responder
H40.041 …… right eye
H40.042 …… left eye
H40.043 …… bilateral
H40.049 …… unspecified eye
H40.05 Ocular hypertension
H40.051 …… right eye
H40.052 …… left eye
H40.053 …… bilateral
H40.059 …… unspecified eye

Related ROB Video & Articles

ICD-10: Embrace a Tool that Elevates Patient Care

Code Correctly to Eliminate Costly Losses

Rejected Claims: Understand Why It Happened and Ensure Future Payments

Coding and Billing Key: Quality Record Keeping

Maria Sampalis, OD, is the owner of Sampalis Eye Care in Warwick, RI, and North Dartmouth, Mass. To contact her: msampalis@hotmail.com

Click to comment

You must be logged in to post a comment Login

Leave a Reply

To Top