Thousands of new ICD-10 codes will go into effect on Oct. 1.

Use AOA resources to prepare for changes to ICD-10 codes

A backlog of thousands of new ICD-10 codes—including about 750 changes that expand and refine diagnosis codes related to optometry—will go into effect on Oct. 1.

Altogether, there are more than 5,500 new codes: 3,651 hospital inpatient procedure codes (ICD-10-PCS) and 1,900 diagnosis codes (ICD-10-CM) have been added by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC). The new release reflects the backlog of codes that were not implemented due to a partial freeze prior to October 2015, when CMS made the initial transition to ICD-10 codes.

“Proper preparation will aid in this transition.”

What's different for doctors of optometry among the newly released standardized codes for medical conditions and procedures? Some additions and some deletions.

"There are now laterality and severity codes for diabetic retinopathy, macular degeneration, retinal vascular occlusions and open angle glaucoma," says Harvey Richman, O.D., a member of the AOA Third Party Center (TPC) Executive Committee and one of AOA's Coding Experts.

"Further delineation on orbital trauma was included," Dr. Richman says. "More codes were added on concussion and the visual effects. There are additionally more options for stroke patients relating to cognitive impairments, visual spatial difficulties, and attention and memory problems."

The TPC Executive Committee advocates on behalf of optometry's participation in third party health care programs. Committee members strive, among other things, to be the "voice" of optometry to national code-setting organizations and educate AOA members on the issues so doctors of optometry can succeed in the managed care environment of their practices.

A complete list of the new codes was published in March by CMS so providers would have more time to prepare for their Oct. 1 launch, but Dr. Richman urges AOA members to order and review AOA's optometry-friendly coding resources rather than consult the CMS site.

Use AOA resources to prepare                                                                                                     

"Proper preparation will aid in this transition," says Rebecca Wartman, O.D., also a member of the TPC Executive Committee and an AOA Coding Expert.

To prepare for implementation of the new codes, members can:

  • Make sure they are using and understanding the current code set.
  • Order the 2017 AOA Codes for Optometry book with 2017 Express Mapping Card and AMA CPT Professional Edition at AOA Marketplace. Shipping will begin in mid-September.

From ICD-9 to ICD-10

Doctors of optometry have some experience transitioning to new ICD-10 codes.

About a year ago, CMS transitioned from the outdated ICD-9 to new ICD-10 codes. The ICD-9 codes, more than 30 years old, contained terminology that was neither expandable nor reflected current medical practices. There was apprehension among providers ahead of the new ICD-10 codes.

Dr. Wartman predicts less anxiety this time around for the latest release of ICD-10 updates.

"While all the changes due to ICD-10 seemed overwhelming prior to October 2015, the actual implementation was not too difficult," Dr. Wartman says. "The new changes for 2017, adding more codes, will not be too onerous."

She adds, "Many of the additional codes are adding laterality to existing codes—meaning that the eye impacted will now be included in the code that is reported, increasing the number of codes necessary to properly report."

To avoid some common coding mistakes that could cause a claim to be denied, doctors of optometry and their staff members should make sure they are:

  • Using the most current and correct codes.
  • Using every digit in the codes—don't truncate them.

The AOA stands ready to assist members with coding questions and will provide resources and support as these new code changes take place.

Click here to learn more about the ICD-10 changes effective Oct. 1, and click here to order the 2017 AOA Codes for Optometry book with 2017 Express Mapping Card and AMA CPT Professional Edition.

August 15, 2016

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