The Centers for Medicare & Medicaid Services (CMS) has released the updated ICD-10-CM codes for 2019 – which will be effective Oct. 1, 2018 – and if you haven’t already guessed, the revisions mostly aim to make the codes more specific. Get ready to take a closer look at the documentation to hunt down the right code, because now you’ll have to know not only which eye (right or left), but in some cases even which eyelid!
The 2019 ICD-10-CM updates include changes to codes for blepharitis, Meibomian gland dysfunction, rosacea conjunctivitis, and much more, according to coding instructor Jeffrey Restuccio in his 2019 Coding Updates Virtual Boot Camp for the ophthalmology specialty. Here are some of the key changes to ICD-10-CM for ophthalmology coders…
Get Specific: Select Which Eye (and Eyelid)
The changes to Chapter 7, Diseases of the Eye and Adnexa, mostly encompass new specifications for upper or lower eyelids, according to . Other revisions simply involve adding a specification for the eye as right, left, or bilateral.
The following new codes specify not only which eye, but also the upper versus lower eyelid:
- 15 – Paralytic ectropion of eyelid
- 151, right upper eyelid
- 152, right lower eyelid
- 153, right eye, unspecified eyelid
- 154, left upper eyelid
- 155, left lower eyelid
- 156, left eye, unspecified eyelid
- 157, unspecified eye, unspecified eyelid
- 88 – Meibomian gland dysfunction of eyelid
- 881, right upper eyelid
- 882, right lower eyelid
- 883, right eye, unspecified eyelid
- 884, left upper eyelid
- 885, left lower eyelid
- 886, left eye, unspecified eyelid
- 889, unspecified eye, unspecified eyelid
- 88A, right eye, both eyelids
- 88B, left eye, both eyelids
Pay attention: Meibomian gland dysfunction is a new category of ICD-10 codes, which CMS has placed under H02.8 – Other specified disorders of eyelid, noted the American Society of Ophthalmic Administrators (ASOA).
CMS Revised Blepharitis, Lagophthalmos Codes, Too
A multitude of other ICD-10 eye codes now specify the right or left eye but include both “upper and lower eyelids” in the code descriptors. These codes include:
Blepharitis
- 00 – Unspecified blepharitis
- 00A, right eye, upper and lower eyelids
- 00B, left eye, upper and lower eyelids
- 01 – Ulcerative blepharitis
- 01A, right eye, upper and lower eyelids
- 01B, left eye, upper and lower eyelids
- 02 – Squamous blepharitis
- 02A, right eye, upper and lower eyelids
- 02B, left eye, upper and lower eyelids
Lagophthalmos
- 20 – Unspecified lagophthalmos
- 20A, right eye, upper and lower eyelids
- 20B, left eye, upper and lower eyelids
- 20C, bilateral, upper and lower eyelids
- 21 – Cicatricial lagophthalmos
- 21A, right eye, upper and lower eyelids
- 21B, left eye, upper and lower eyelids
- 21C, bilateral, upper and lower eyelids
- 22 – Mechanical lagophthalmos
- 22A, right eye, upper and lower eyelids
- 22B, left eye, upper and lower eyelids
- 22C, bilateral, upper and lower eyelids
- 23 – Paralytic lagophthalmos
- 23A, right eye, upper and lower eyelids
- 23B, left eye, upper and lower eyelids
- 23C, bilateral, upper and lower eyelids
Conjunctivitis
- 82 – Rosacea conjunctivitis
- 821, right eye
- 822, left eye
- 823, bilateral
- 824, unspecified eye
Note: CMS also added a statement to code the first underlying rosacea dermatitis (L71.-) under H10.82 – Rosacea conjunctivitis, ASOA pointed out.
Check Out a Few More New Eye Codes
Under H57 – Other disorders of eye and adnexa, and H57.8 – Other specified disorders of eye and adnexa, CMS has added a few brand new codes:
- 81 – Brow ptosis
- 811, right
- 812, left
- 813, bilateral
- 819, unspecified
- 89 – Other specified disorders of eye and adnexa
Not so fast: Although some of the new and revised eye codes give you options for “unspecified” when the documentation doesn’t offer up enough information to select a more accurate code, you’ll notice that many of the codes don’t have an unspecified coding choice. You might as well get used to this, as CMS is pushing providers and coders toward more specific coding and documentation that paints a full picture of the patient’s health status.
Stay Alert for More Changes
Don’t forget: The ICD-10 updates are just the first wave of changes – the CPT and Medicare updates for FY 2019 are also on the horizon. You need to stay current on all these revisions to maximize deserved reimbursement, improve your coding accuracy and documentation skills, and boost your practice’s financial success, Restuccio stresses.
