Optometry Coding & Billing Alert

Published on Mon Jul 28, 2014 PDF

In 2015, you’ll no longer need to report an additional Dx code to indicate glaucoma stage

The aim of ICD-10 to contain as much information as possible in a single diagnosis code is certainly expressed in the range of glaucoma codes (H40). When ICD-10 comes into effect on Oct. 1, 2015, you’ll be faced with about 250 codes in that range, some of which stretch to seven characters. 

The seventh character represents the stage of the glaucoma. Currently, for certain ICD-9 codes, coders are directed to use an additional code from the 365.70-365.74 range to indicate glaucoma stage. In ICD-10, glaucoma stage will be indicated by the seventh character:

• 1 — mild
• 2 — moderate
• 3. — severe
• 4 — indeterminate.

Example: In ICD-9, primary open-angle glaucoma in the early stage would be described with 365.11 (Primary open angle glaucoma) and 365.71 (Early stage glaucoma).

In ICD-10, you would report one code: H40.11X1 (Primary open-angle glaucoma, mild stage).

The sixth character in the glaucoma ICD-10 codes represents the location of the glaucoma:

• 1 — right eye
• 2 — left eye
• 3 — bilateral
• 9 — unspecified eye

Example: In ICD-9, moderate-stage psuedoexfoliation glaucoma in the right eye would be described with 365.52 (Pseudoexfoliation glaucoma) and 365.72 (Moderate stage glaucoma). There is no way in ICD-9 to indicate which eye is affected.

In ICD-10, you would report H40.1412 (Capsular glaucoma with pseudoexfoliation of lens, right eye, moderate stage).

In some cases, such as H40.11X1, the “X” is used as a placeholder character to allow for future expansion of the code. Coders must still include the “X” for the code to be considered valid.

Learn more: For more information on ICD-10, and detailed ICD-9-to-ICD-10 mapping, visit https://www.aapc.com/codes/.