Ophthalmology and Optometry Coding Alert

Tip: Start documenting clearer diagnoses now to prepare for ICD-10 in 2013.

If you've felt that your glaucoma diagnoses could use a bit more specificity, ICD-9 will deliver this October if the proposed list of new, deleted, and revised diagnosis codes becomes final.

The list of ICD-9 changes was recently posted to the CMS Web site, and includes the final full set of changes that the agency will make to ICD-9 codes. After the new codes take effect on Oct. 1, 2011, CMS will only add new ICD-9 codes on an emergency basis as it prepares to switch over the diagnosis coding system to ICD-10.

Your ICD-9 manual will boost its glaucoma offerings with the following changes proposed to take effect on Oct. 1 of this year:

Revised code:

• 365.01 -- Borderline glaucoma; open angle with borderline findings, low risk

New codes:

• 365.05 -- Borderline glaucoma; open angle with borderline findings, high risk
• 365.06 -- ...primary angle closure without glaucoma damage
• 365.70 -- Glaucoma stage, unspecified
• 365.71 -- Mild stage glaucoma
• 365.72 -- Moderate stage glaucoma
• 365.73 -- Severe stage glaucoma
• 365.74 -- Indeterminate stage glaucoma.

Get ready: These new codes should help prepare coders and physicians for the transition to more specific diagnosis codes with ICD-10 in 2013, experts say. Physicians should start documenting clearer diagnoses and co-morbidities now to prepare for ICD-10 coding. "Coders and billers will have a difficult time determining the most accurate ICD-10 code when a physician writes 'Open angle glaucoma' without additional detail," notes Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, Director of Network Oversight at Mount Sinai Medical Center Compliance Department in New York City. "Physicians and coders should become acquainted with the new ICD-9 codes and the need for clear diagnostic impressions to be documented in the medical record to prepare for the changes effective October 1, 2011."

Do this: Today isn't too soon to start thinking about ICD- 10, says Helen Avery, CPC-I, CHC, manager of revenue cycle services at Los Angeles-based Sinaiko Healthcare  Consulting Inc. The more familiar you are with the changes, the easier the transition will be. Although you shouldn't start your intensive, in-depth ICD-10 training until six to nine months before implementation, you can prepare in other ways now. "Obtain education and understanding early on so that you will be well equipped," Avery says.

To read the complete list of proposed changes to the ICD-9 code set, visit www.cms.gov/AcuteInpatientPPS/IPPS2012/itemdetail.aspfilterType=none&filterByDID=9&sortByDID=1&sortOrder=ascending&itemID=CMS1246728&intNumPerPage=10.