Get answers to your coding questions

November 14, 2016
Got a coding question? AOA’s Coding Experts are here to help.

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 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 .

Ask the coding experts

If you have any questions regarding Medical Records and Coding, please submit them to Coding Experts Submission Form and one of our coding experts will be in contact with you.
Related News

If it sounds too good to be true, it probably is

In assessing new products, consider first what is best for your patients and practice—but also consider reimbursement related to new equipment.

New E/M codes: Is time on your side?

While how time is considered has changed, it is critical to remember that usage of the prolonged service modifier also has changed.

Coding ethically: What to do when a coding decision is made incorrectly

The AOA Ethics and Values Committee releases topical and timely case study on coding abuse and what to do about it once suspected.