Optometry Coding & Billing Alert

Question: If I find that a common ICD-9 code that I use doesn’t have a direct crosswalk to ICD-10, will I be able to use “other” or “other specified” codes in ICD-10?

Tennessee Subscriber

Answer: When ICD-10 went into effect on Oct. 1, 2015, coders saw that not all codes in ICD-9 have a direct crosswalk to ICD-10 codes.

That doesn’t mean that you’ll automatically select an “other” or “other specified” code for the condition, however. It may be that ICD-10 provides multiple codes that provide more granularity for reporting the condition you’ve commonly reported with a single code in ICD-9. For instance, ICD-10 introduces laterality for specimen site, so a single ICD-9 code may translate to a comparable code for “right,” “left,” and “unspecified” sites.

You should reserve codes that state “other” or “other specified” for when the information in the medical record provides detail for which a specific code does not exist. You should use “unspecified” codes when the information in the medical record is insufficient to assign a more specific code.