Ophthalmology and Optometry Coding Alert
Prepare for More Specificity in Strabismus Coding
New diagnosis codes specify which eye is affected.
When ICD-10 becomes effective, you’ll have a few more options for coding strabismus, particularly esotropia and exotropia. Here are the details you’ll need to properly report the new codes.
Under ICD-9, both esotropia (convergent horizontal strabismus) and exotropia (divergent horizontal strabismus) are given specific five-digit codes to narrow down whether the condition is monocular, and which pattern the patient displays. For example, the ICD-9 codes for esotropia are:
Know your terms: A monocular esotropia is evident in one eye only; a patient with alternating esotropia can alternate fixation between eyes so that at one time the right eye can remain fixed and the left turn inward, and at another time the left remain fixed and the right turn inward. “A pattern” and “V pattern” refer to conditions in which the pattern of fixation varies depending on whether the patient is gazing upward or downward — in an A pattern, the eyes become more divergent as the gaze turns downward, and in a V pattern, the eyes converge when the gaze turns downward.
ICD-10 maintains the specificity between monocular and alternating esotropia, and the references to patterns, but adds the ability to specify which eye — left or right — is affected:
The ICD-10 codes for exotropia show the same detail as the esotropia codes:
Ophthalmology and Optometry Coding Alert
- CCI Update:
Watch for New Injection, Visual Function Screening Bundles
Tip: Check modifier indicators for ability to report codes separately. If you’re in the habit [...] - ICD-10-CM:
Prepare for More Specificity in Strabismus Coding
New diagnosis codes specify which eye is affected. When ICD-10 becomes effective, you’ll have a [...] - Modifiers:
Master Modifier 25 Following These Expert Tips
Haphazardly using 25 on all claims will lead to payer scrutiny. With payers cracking down [...] - Reader Question:
Only Report One 66821 Performed on Same Eye During Global
Question: The doctor performed a YAG laser capsulotomy. Six months later, during a return visit, the [...] - Reader Question:
Supply Reimbursement Depends on POS
Question: My doctors are concerned that our practice is losing money on supplies, such as surgical [...] - Reader Question:
Unbundle 67904 and 15823 Under These Clinical Circumstances
Question: Our oculoplastic surgeon performed levator resection and blepharoplasty on both upper eyelids in the same [...] - You Be the Coder:
Excision After Incision
Question: The ophthalmologist incised a patient’s conjunctival cyst (68020). One week later, the patient came back [...]
