New Demodex blepharitis codes available for optometrists

Beginning on October 1, doctors of optometry can use new diagnostic codes for Demodex blepharitis. 

Thanks to advocacy by the AOA’s Coding and Reimbursement Committee, codes B88.01 (infestation by Demodex mites) and B88.09 (other acariasis) were added to the ICD-10 to provide more specificity to infectious and parasitic diseases and infestations. More details were also added to code H01.8 (other specified inflammations of eyelid). 

“The Demodex code is good news in that it provides a way to truly track Demodex infestations and the impact on ocular health,” says Rebecca Wartman, O.D., chair of the AOA’s Coding and Reimbursement Committee. 

Treatment protocols for an infestation of Demodex mites have advanced, but there was no appropriate code for the disease until now, says committee member Harvey Richman, O.D. “When documenting disease in a chart, optometrists are reminded to always utilize the most specific diagnosis code possible,” he says. 

The AOA requested the new codes at the March 2024 ICD-10 Coordination and Maintenance meeting. The codes were approved in September 2024. 

The AOA initially advocated for a single code to describe Demodex infestations and Demodex blepharitis, but the ICD-10 committee opted to create one code for the Demodex infestation and another for the blepharitis and eyelid complications that typically arise from the infestation, Dr. Wartman says. 

“While the requirement for needing two codes to describe a condition is not ideal,” she says, “at least this serious ocular condition can now be tracked for public health purposes.” 

More code proposals in the works 

The AOA’s Coding and Reimbursement Committee is working on two other proposals, Dr. Wartman says.  

The first is for bilateral, upper and lower lid codes for some eyelid condition codes, so providers can use a single code rather than separate codes for each lid or eye. The second proposal involves creating codes to describe the various types of dry eye syndrome or keratitis sicca conditions. 

“Currently, these conditions are only described in very broad terms, but the types of dry eye syndrome can be treated very differently and should have codes to distinguish them,” Dr. Wartman says. “We hope that having more options for coding dry eye syndrome by type will ease some of the reimbursement issues for appropriate in-office and pharmaceutical therapies for each patient's specific type of dry eye syndrome.” 

Reappointments for Drs. Wartman and Richman 

Dr. Wartman and Dr. Richman have been reappointed to important AOA coding advocacy positions with the American Medical Association (AMA) through May 2028, ensuring optometry has immediate input on decisions affecting coding and billing. 

Dr. Wartman was reappointed as primary AMA Health Care Professional Advisory Committee (HCPAC) Advisor. Dr. Richman was reappointed as the alternate HCPAC Advisor. 

They will represent AOA at the next meeting of the AMA’s Current Procedural Terminology (CPT) Editorial Panel this week in Chicago. 

Access AOA coding resources 

The AOA is optometry’s leading source for education on medical billing and coding. Here are three ways AOA members can make the most of AOA’s coding resources: 

1. Ask the Coding Experts. AOA’s Coding Experts are available to answer questions about ICD-10 and other coding topics through this online form. Also, find the experts' regular column on the AOA Focus content hub.
2. Use AOA Coding Today. This online, comprehensive database contains information in real time for CPT, ICD-10 and HCPCS coding and research. AOA Coding Today is tailored specifically to optometry and assists doctors and staff in correct reimbursement and compliance with an easy-to-use code diagnosis ability based on region.
3. Watch AOA's coding webinars. Browse AOA's webinar library for additional coding tutorials.    

Access AOA's Medical Records and Coding page.