Still wasting time scouring the web for the details you need to code an eye care procedure? Time to arm yourself with laser-focused insights on eye-care-specific CPT® and ICD-10 code additions, deletions, and revisions for 2019.
In his live presentation, “CPT®, ICD-10, and Medicare Updates,” certified coding instructor Jeffrey Restuccio covers Medicare updates, LCD changes, coding for new/experimental procedures, carrier-specific coding rules, medical necessity, and many more ophthalmology-specific topics—delivering all the information you need in one place, and answering tough questions the manuals don’t address. This ophthalmology session is part of ProfEdOnDemand’s essential 2019 Coding Updates Virtual Boot Camp, which equips attendees for a maximum-reimbursement kind of New Year.
To get you started, here’s a quick preview of the newest ophthalmology ICD-10-CM and CPT® code changes. But do remember that this list is not all-inclusive. (For full lists of codes, visit the CDC’s and AMA’s websites.)
Unblock Your Approach to Meibomian Gland Dysfunction
One of the biggest ophthalmology ICD-10 code changes for 2019 is the addition of 9 codes to describe which eyelid was affected by meibomian gland dysfunction. They are:
- 881 and H02.882 for right upper and right lower eyelid, respectively
- 883 for right eye, unspecified eyelid
- 884 and H02.885 for left upper and left lower eyelid, respectively
- 886 for left eye, unspecified eyelid
- 889 for unspecified eye and unspecified eyelid
- 88A for right eye, both eyelids
- 88B for left eye, both eyelids
Focus in on New Rosacea Conjunctivis Codes
To make your coding more specific, another one of the noteworthy ophthalmology ICD-10 code changes this year is the addition of new codes for rosacea conjunctivitis, which specify the affected eye:
- 821, right eye
- 22, left eye
- 23, bilateral
- 829, unspecified eye.
Don’t Get Burned by New Blepharitis Codes
A third set of ophthalmology ICD-10 code changes includes blepharitis codes. For these, you just need to know which eye and which type of blepharitis to report.
Unspecified blepharitis
- 00A, both eyelids of right eye
- 00B, both eyelids of left eye
Ulcerative blepharitis
- 01A, both eyelids of right eye
- 01B, both eyelids of left eye
Squamous blepharitis
- 02A, both eyelids of right eye
- 02B, both eyelids of left eye
Know Which Way Is Up—and Down
Many 2019 ophthalmology ICD-10 code changes deleted codes that specified the “right” or “left” eyelid and replaced them with codes that now also specify the “upper” or “lower” portion of each right/left eyelid. Codes that follow these edits include:
- 111-122: Malignant melanoma
- 111-C4A.122: Merkel cell carcinoma
- 1121-1192: Basal cell carcinoma
- 1221-1292: Squamous cell carcinoma
- 1321-1392: Sebaceous cell carcinoma
More: There are also several new ICD-10 codes that specify the upper/lower eyelid on each eye. These include codes for melanocytic nevi (D22.121-122), paralytic ectropion (H02.151-159), lagophthalmos (H02.220A-H02.23C), and brow ptosis (H57.811-819).
Shed Some Light on New Electroretinography Codes
Key ophthalmology CPT® code changes for this year include the addition of codes addressing electroretinography (ERG). In addition to the standard procedure, ERGs can be pattern (PERG) or multifocal (mfERG). These new codes are:
- 0509T, ERG with interpretation and report, PERG
- 92273, ERG with interpretation and report; full field (ie, ffERG, flash ERG, Ganzfeld ERG)
- 92274, ERG with interpretation and report; mfERG
More: Two important new CPT® codes not dealing with ERGs are 0514T (intraoperative visual axis identification using patient fixation) – which should be listed separately in addition to the primary procedure code – and 81333, TGFBI (transforming growth factor beta-induced) gene analysis, common variants.
In his upcoming ophthalmology coding webinar Restuccio shares a “Why Do I Care?” approach—that is, the real-word benefits of knowing the 2019 code changes—that will help motivate you to stay focused on improving your coding knowledge.
