Ophthalmology and Optometry Coding Alert

Even shingles can affect the eyes – know how to code this condition.

If you’ve never seen a chart coded with herpes viral ocular disease before, chances are that you will eventually, so knowing how to report these services will be essential to collecting for the visits. Check out these tips for coding herpetic eye diseases.

First, Know What It Is

The herpes virus can impact the eyes in a variety of ways, from a small infection to a serious condition that can cause blindness. Patients can contract the condition from herpes simplex (which typically causes cold sores) or from herpes zoster (which causes shingles or chicken pox).

Patients often present with pain in their eyes as an early symptom of the condition, as well as occasional decreased vision, redness, eyelid ulcers or light sensitivity. The eye care specialist will examine the patient using a slit lamp and fluorescein dye, and will come to the definitive diagnosis.

Here’s How to Code

To report these conditions, you’ll start with the B00.5 section of the ICD-10 manual (Herpes Simplex codes), coding out to a fifth character as follows:

• B00.50 – Herpesviral ocular disease, unspecified. You’ll report this code when the eye care specialist definitively confirms that the patient has herpes viral disease affecting the eye but you have no further details.
• B00.51 – Herpesviral iridocyclitis. This condition causes inflammation to the iris and tissues around it stemming from the herpes virus.
• B00.52 – Herpesviral keratitis. This is the condition that your physician will most commonly treat since it occurs more than the other diagnoses. Typically, this condition will affect the epithelium of the cornea and doesn’t usually cause permanent damage.
• B00.53 – Herpesviral conjunctivitis. If the provider identifies conjunctivitis (also referred to as “pink eye” as being caused by the herpes virus, you’ll select this code.
• B00.89 – Other herpesviral infection. This suggests that the patient has a specified disease that does not have a code assigned to it. For instance, herpesviral whitlow would be included in this code.

If the physician documents herpes viral disease but does not identify the type, you should look through the documentation to try and find more details so you can select the most accurate code from among the options above.

The Herpes Zoster codes start at the B02.3 section of the ICD-10 manual, also coding out to a fifth character, says Gina Vanderwall, OCS, CPC, CPPM, financial counselor with Finger Lakes Ophthalmology in Canandaigua, New York.

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