Question: How should I bill for a routine exam with the diagnosis post-keratoplasty in the right eye, and keratoconus in the left eye? What would the correct diagnosis codes be?
Alabama Subscriber
Answer: Before Oct. 1, 2015, report ICD-9 code 371.60 (Keratoconus, unspecified), 371.61 (Keratoconus, stable condition) or 371.62 (Keratoconus, acute hydrops) for the keratoconic left eye. To show the post-keratoplasty status in the right eye, report V42.5 (Organ or tissue replaced by transplant; cornea).
Keep in mind, however, that some insurers balk at reimbursing for V-codes. Policies vary depending on which specific carrier you’re billing. If the carrier denies your claim with V42.5, you can try reporting 367.22 (Irregular astigmatism) instead.
ICD-10: After ICD-10 takes effect on Oct. 1, 2015, your coding will change. Report one of the following:
Instead of ICD-9 code V42.5, you would report ICD-10 code Z94.7 (Corneal transplant status).