ICD-10 Coding for Contact Lens Problems The EyeCodingForum

[Pages:32]ICD-10 Coding for Contact Lens Problems

The

Jeffrey Restuccio, CPC, CPC-H, MBA Memphis TN

(901) 517-1705 jeff@



1

Coding for Contact Lens Complications

? Many common conditions/diseases are not listed in the current ICD-9 manual. How will they translate to ICD-10? Will it correct all the omissions and incorrect descriptions currently found in ICD-9?

? For the most part, no. ? Yes, Dry Eye Syndrome will now be part of the ICD-10 code

description.

H04.121 Dry eye syndrome of right lacrimal gland

? But many will continue to retain international descriptions that are different from common terms used in the United States.



2

Top Five Contact Code Problem ICD-9 Codes/Conditions

? ICD-9 and Description

ICD-9

Description

368.8 Blurred Vision

379.91 Eye Pain

379.93 Redness of Eyes

375.15 Dry Eyes

368.2 Double Vision/diplopia

This list includes about 80% of visits for contact lens-related problems.



3

ICD-10 Crosswalk

? Note separate diplopia and double vision codes.

Other specified disorders of eye and adnexa [blurred 1) H57.8 vision crosswalk] 2) H57.13 Ocular pain, bilateral [four codes] 3) H57.8 Other specified disorders of eye and adnexa [redness]

4) H04.121 Dry eye syndrome of right lacrimal gland [four codes] 5) H53.2 Diplopia [ICD-9 crosswalk to 368.2]

Other subjective visual disturbances [Includes: H53.19 Double vision; ICD-9 crosswalk: 368.15]

368.15: Subjective visual disturbances: other visual distortions and entoptic (visual effects whose source is within the eye itself) phenomena



4

Common Coding Errors

371.82 375.15

Corneal Disorder due to Contact Lens Corneal Edema due to Wearing of Contact Lens [this is an error per ICD-9]

? The two codes are recommended above but 375.15 is clearly incorrect per ICD-9 guidelines.

371.15

Corneal pigmentations and deposits: other deposits associated with metabolic disorders [actual ICD-9 description]

Other corneal disorders: corneal disorder due to 371.82 contact lens

Excludes corneal edema due to contact lens (371.24)



5

Correct Contact ICD-10 Codes

? Correct ICD-9 code

Corneal edema: corneal edema due to wearing of 371.24 contact lenses

Corneal edema secondary to contact lens, H18.219 unspecified eye

371.82 Corneal Disorder due to Contact Lens H18.829 Corneal disorder due to contact lens, unspecified eye



6

Other conditions

? How does one code for: more serious conditions like corneal hypoxia, infiltrates, and microbial keratitis?



7

Terms and definitions

? SEAL: Superior Epithelial Arcuate Lesion: It is a white lesion in the superior cornea that can be up to 0.5 mm wide and from 1 mm to 5 mm long.

? CLARE: Contact Lens-induced Acute Red Eye: A sudden onset of a corneal infiltrative event observed during extended wear of hydrogel contact lenses that is always associated with sleep. Patients report waking up with irritation or pain, redness and watery eyes. Sometimes, these symptoms are not noticed until soon after waking (HPI: timing).

? CLPU: Contact Lens-induced Peripheral Ulcer: A circular, wellcircumscribed, dense, yellowish-white, focal corneal infiltrate (0.2 mm to 2.0 mm in diameter) located in the peripheral to midperipheral cornea. It is always located in the anterior stroma and has a complete loss of overlying epithelium. Symptoms can vary but may include pain or soreness, irritation and watering.



8

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download