ICD-10 Codes for Optometry. Eric Botts, OD Macomb, IL

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1 ICD-10 Codes for Optometry Eric Botts, OD Macomb, IL

2 Disclosures I am a member of Speakers Bureau for Zeissmeditec and ALCON but have no financial interest in these companies. I am the owner of OBC Billing Specialists.

3 OBC Billing Specialists Services We Provide 1. Submit Medical/Routine Claims Medical Claims Routine Vision Claims Bill Patient for Balance Due 2. Credential doctors for all insurance plans 3. Medical Coding Booklet and Forms 4. Training Videos for coding/billing

4 Why Change to ICD-10? ICD-10 provides more specific descriptions of medical disease/condition Allows for future changes in the medical coding arena Better quantification of disease state More specific coding results in fewer coding errors

5 When will change occur? Change is scheduled for Oct. 1 st, 2015

6 How do you Prepare? Convert to Electronic Health Records Anything with ICD-9 codes on it needs to be updated to ICD-10 Be sure your clearinghouse and EHR are ready for switch Worst case scenario is delayed reimbursement due to payors not ready for switch on Oct. 1, 2015

7 Organization of ICD-10 H00-H05 Disorders of the eyelid, lacrimal system, and orbit H10-H11 H15-H22 Disorders of the conjunctiva Disorders of the sclera, cornea, iris, and ciliary body H25-H28 H30-H36 H40-H42 Disorders of the lens Disorders of the choroid and retina Glaucoma

8 Organization of ICD-10 H43-H44 H46-H47 Disorders of the vitreous body and globe Disorders of optic nerve and visual pathways H49-H52 H53-H54 H55-H57 H59 Disorders of ocular muscles, binocular movement, accommodation, and refraction Visual disturbances and blindness Other disorders of the eye and adnexa Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified

9 How are ICD-10 different from ICD-9? ICD-10 codes differ from ICD-9 because they are alphanumeric and contain 3-7 characters. ICD-9 > ICD > H25.011

10 How are ICD-10 the same? Used to classify disease Use them to be reimbursed by insurance payors

11 How do we convert from ICD-9 to ICD-10? General Equivalence Mapping(GEM) No match-3% 1 to 1 exact mapping-24% 1 to 1 approximate mapping- 68% 1 to many mapping-5% Source: American Medical Association

12 1 to 1 Exact Mapping ICD = Degeneration of macula = Nonexudative macular degeneration = Exudative Macular degeneration ICD-10 H35.30 Unspec macular degener H35.31 Nonexudative AMD H35.32 Exudative AMD

13 1 to 1 Approximate Mapping ICD = Macular Puckering ICD-10 H Right eye or H Left eye or H Bilateral or H Unspecified Macular Puckering

14 1 to Many Mapping ICD Type 1 Controlled Diabetic w/ ophthalmic issues Background DR Diabetic macular edema ICD-10 E Type 1 Diabetes Mellitus with Diabetic Macular Edema = E10.311

15 Refractive ICD-10 Codes Hyperopia H52.00 Hyperopia, unspecified eye H52.01 Hyperopia, right eye H52.02 Hyperopia, left eye H52.13 Hyperopia, bilateral Myopia H52.10 Myopia, unspecified eye H52.11 Myopia, right eye H52.12 Myopia, left eye H52.13 myopia, bilateral

16 Primary Open Angle POAG Glaucoma H40.10X0 POAG, stage unspecified H40.11X1 POAG, mild stage H40.10X2 POAG, moderate stage H40.10X3 POAG, severe stage H40.10X4 POAG, indeterminate stage No bilaterality for suspect, POAG, narrow angle or ocular hypertension

17 Ocular Injuries Corneal abrasion Injury of conj/corneal abrasion w/o FB S05.00XA unspecified eye, initial encounter S05.01XA right eye, initial encounter S05.02XA left eye, initial encounter S05.00XD unspecified eye, subsequent enc S05.01XD right eye, subsequent encounter S05.02XD left eye, subsequent encounter S05.00XS unspecified eye, sequela S05.01XS right eye, sequela S05.02XS left eye, sequela

18 Ocular Injuries continued Initial encounter- first exam of injury Subsequent encounter- follow up visit Sequela- after healing is complete, patient returns with complications resulting from initial injury Example: recurrent corneal erosion occurs in same location as corneal abrasion

19 Age-related Cataract Last digit 1-RT, 2-LT, 3-bilateral H25.03[1,2,3] Ant subcap polar cat H25.04[1,2,3] Post subcap polar cat H25.01[1,2,3] Cortical cat H25.0[1,2,3] Nuclear cat H25.2[1,2,3] Hypermature cat

20 Other Cataracts Last digit 1-RT, 2-LT, 3-bilateral H26.04[1,2,3] Ant subcap infant cat H26.05[1,2,3] Post subcap infant cat H26.01[1,2,3] Infant cortical cat H26.03[1,2,3] Infant/juvnile nuclear H26.13[1,2,3] Total traumatic cat

21 After-cataract Obscuring Vision ICD-10 is not specific for this so use H26.49[1,2,3] Other secondary cataract

22 Dry Eye H Dry eye syndrome of RT lacrimal gland H Dry eye syndrome of LT lacrimal gland H Dry eye syndrome of bilateral lacrimal glands H Dry eye syndrome of unspecified lacrimal gland

23 Punctate Keratitis H PK RT eye H PK LT eye H PK Bilateral H PK unspec Trichiasis H Trich w/o entrop RT upper lid H Trich w/o entrop RT lower lid H Trich w/o entrop RT unsp lid H Trich w/o entrop LT upper lid H Trich w/o entrop LT lower lid H Trich w/o entrop LT unsp lid H Trich wo entrop unsp eye and unsp lid

24 Corneal Foreign Body T15.00XA- FB unsp cornea, 1 st visit T15.01XA- FB in RT cornea, 1 st visit T15.02XA- FB in LT cornea, 1 st visit T15.00XD- FB unsp cornea, subseq T15.01XD- FB RT cornea, subseq visit T15.02XD- FB LT cornea, subseq visit T15.00XS- FB unsp cornea, sequela T15.01XS- FB RT cornea, sequela T15.02XS- FB LT cornea, sequela

25 Type 2 Diabetes with Ocular Manifestations E Typ 2 retinphy w/ edema E Typ 2 retinphy w/o edema E Typ 2 mild nonprolf w/edema E Typ 2 mild nonprof w/o edema E Typ 2 mod nonprof w/ edema E Typ 2 mod nonprof w/o edema E Typ 2 sever nonprof w/ edema E Typ 2 sever nonprof w/o edema E Typ 2 prolif w/ edema E Typ 2 prolif w/o edema

26 Type 1 Diabetes with Ocular Manifestations E Typ 1 retinphy w/ edema E Typ 1 retinphy w/o edema E Typ 1 mild nonprolf w/edema E Typ 1 mild nonprof w/o edema E Typ 1 mod nonprof w/ edema E Typ 1 mod nonprof w/o edema E Typ 1 sever nonprof w/ edema E Typ 1 sever nonprof w/o edema E Typ 1 prolif w/ edema E Typ 1 prolif w/o edema

27 Will CPT codes change with ICD-10? NO, you will continue to use same codes for exams and procedures 99xxx, 92xxx and s-codes for exams 92250, 92083, will be the same as with ICD-9 codes

28 Will modifiers for CPT codes still be necessary? Yes, and you will need to match them up with correct ICD-10 code for bilateral and unilateral procedures Example: Insert punctal plug (68761) lower left (E2) and lower right (E4) requires H Dry Eye Syndrome of bilateral lacrimal glands

29 Benign Neoplasm Fundus photos

30 ICD-10 D Benign Neoplasm Fundus photos

31 Benign Neoplasm Fundus Photo Refraction Office visit

32 ICD-10 D Benign Neoplasm Fundus Photos Refraction OV

33 99204-Office Visit Fundus photos TVF Gonio Refraction Pach

34 ICD-10 H40.11X2-POAG, Moderate stage H25.13-Nuclear Cataract, Bilateral

35 Ant. Seg OCT ON OCT Office visit Visual Evoked Potential

36 ICD-10 H40.11X2-POAG, Moderate Stage Ant Seg OCT ON OCT OV Visual Evoked Potential

37 Office visit Refraction

38 ICD-10 H25.89 Age Related Cataract OV Refraction

39 Cataract removal and post op care

40 ICD-10 H Age Related Cataract Surgical Removal of Cataract

41 79 modifier indicates 2 nd cataract removed during post-op of 1st

42 ICD-10 H Age Related Cataract -79 modifier indicates 2 nd cataract removed during global of 1st

43 Covered ICD-9/ICD-10 codes for post-op glasses APHAKIA H27.0[0,1,2,3] Aphakia unspec, RT, LT, Bilateral CONGENITAL APHAKIA Q12.3 Congenital Aphakia V43.1 LENS REPLACED BY OTHER MEANS Z96.1 Presence of intraocular lens

44 V2300- Sphere, trifocal V2781- No-line differential V2020- Frame V2750- Anti-reflective

45 ICD-10 Z96.1- Presence of Intraocular Lens V2300- Sphere, trifocal V2781- No-line V2020- Frame V2750- Anti-reflective

46 ICD-10 H Dry Eye, Bilateral OV Closure of punctum

47 99213-Office visit Closure of punctum

48 ICD-10 H Dry Eye, Bilateral OV Closure of punctum

49 99214-Office visit External photos 87809QW-Adeno Detector

50 ICD-10 B30.0- Adenoviral Keratoconjunctivitis OV External photos QW Adeno Detector

51 99214-Office visit Epilation of lash

52 ICD-10 H Punctate Keratitis, Bilateral H Trichiasis, lower left lid H Trichiasis, lower right lid

53 99214-Office visit Removal of FB Removal of corneal epithelium

54 ICD-10 T15.01XA- Foreign Body in cornea, right eye T15.02XA- FB in cornea, left eye S05.01XA- Corneal abrasion, right eye S05.02XA- Corneal abrasion, left eye

55 92071-Bandage Contact Lens

56 ICD-10 T15.01XA- Foreign Body in cornea, right eye T15.02XA- FB in cornea, left eye S05.01XA- Corneal abrasion, right eye S05.02XA- Corneal abrasion, left eye

57 99204-Office visit Fundus photos Gonio TVF Refraction

58 ICD-10 E Type ll diabetes w retinopathy, w/o macular edema H Posterior subcap cat

59 Retina OCT

60 ICD-10 E Type ll diabetes w retinopathy, w/o macular edema

61 BILLING MEDICAL RESULTS IN: Practicing Optometry Smarter not Harder Eric Botts, OD

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