ICD-10 Code Changes Are Here – Now What?

As of October 1, a backlog of thousands of new ICD-10 codes went into effect, including about 750 changes that expand and refine diagnosis codes related to optometry.  CMS has stated that these updated codes must be used for services provided on or after this date (for more information, see CMS FAQ questions 23 to the end here).

Making ICD-10 Work for You

For doctors of optometry, there have been some additions in the newly released codes, including laterality and severity codes for diabetic retinopathy, retinal vascular occlusions, macular degeneration and open angle glaucoma. Among the code changes important to optometry are:

New codes for amblyopia, AMD and glaucoma

• New codes were added for amblyopia suspect: H53.04--Amblyopia suspect. This subcategory is also broken down by eye, bilateral and unspecified eye.
• New codes were added to the subcategory: H35.31-Non-exudative age-related macular degeneration. This subcategory is further delineated by eye, bilateral and unspecified and these codes also require the addition of a seventh character to designate the stage of the disease.
• New codes were added to the subcategory: H35.32--Exudative age-related macular degeneration. This subcategory is further delineated by eye, bilateral and unspecified and these codes also require the addition of a seventh character to designate the stage of the disease.
• New codes were added to the subcategory H40.11--Primary open-angle glaucoma.  This subcategory is also broken down by eye, bilateral and unspecified eye. Additionally, the stage of glaucoma must also be reported as in previous years.

New and revised codes for post-procedural complications

For doctors that co-manage patients and provide post-surgical care, it will be especially important to be aware of the revisions that have occurred to various codes that capture diagnoses related to post-procedural complications.

• The subcategory H59.3 has been revised to capture additional diagnoses related to post-procedural seroma.
• New codes have been added to distinguish between when complications occur following an ophthalmic procedure and complications that occur following a procedure other than an ophthalmic procedure.

For a complete listing of the new codes, doctors should purchase the 2017 AOA Codes for Optometry resource manual Members can also access AOA Coding Today, a comprehensive online coding resource, at www.aoa.codingtoday.com [member login required]. And, as always, COA-AOA members can direct coding questions to AOA’s coding experts through its online form. Finally, AOA has a pre-recorded webinar regarding the ICD-10 code changes that is available here - the presentation handout is available here.