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Ask the Coding Experts, by Doug Morrow, O.D., Harvey Richman, O.D., Rebecca Wartman, O.D. From the September 2016 edition of AOA Focuspage 51.

AOA's Coding Experts share solutions to your coding conundrums.

I heard that the ICD-10 code H59.311 (post-procedural hemorrhage and hematoma of right eye and adnexa following an ophthalmic procedure) was revised. What is the revision for this code?

Several diagnosis codes related to post-procedural hemorrhages of the eye are being revised. H58.311 is being revised to: post-procedural hemorrhage of right eye and adnexa following an ophthalmic procedure. The additional revisions in this code series are available in the 2017 Codes for Optometry book.

I heard that E08.321 (diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema) has been deleted in the updated ICD-10 code set that goes into effect on Oct. 1, 2016. How should I report this condition going forward?

The revised code set that took effect on Oct. 1 includes greater specificity related to the eye, or eyes, impacted with diabetic retinopathy. You should select the most appropriate code from those listed below:

  • E08.3211: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye
  • E08.3212: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye
  • E08.3213: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
  • E08.3219: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye

I heard that H34.811 (central retinal vein occlusion, right eye) has been deleted in the updated ICD-10 code set that goes into effect on Oct. 1, 2016. How should I report this condition going forward?

In the updated code set, additional codes were added for greater specificity. You should select the most appropriate code from those listed below:

  • H34.8110: Central retinal vein occlusion, right eye, with macular edema
  • H34.8111: Central retinal vein occlusion, right eye, with retinal neovascularization
  • H34.8112: Central retinal vein occlusion, right eye, stable  

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2017 coding resources now available
The 2017 AOA Codes for Optometry book with 2017 Express Mapping Card and AMA CPT Professional Edition are available at AOA Marketplace.

November 14, 2016

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