Changes are coming to ICD-10 diagnosis codes commonly used by optometry and the AOA has the latest information and resources to ready doctors for these imminent revisions.
Effective Oct. 1, these new ICD-10 changes reflect the Centers for Medicare and Medicaid Services' (CMS) desire for increased specificity and complexity with an overall 360 code additions, 250-plus code revisions and 142 code deletions-more than 80 updates, alone, related to conditions treated in optometric practices.
These changes are intended to allow medical practitioners to more accurately capture the vision status of their patients, and allow for doctors to report the category of visual impairment that exists, as defined by the World Health Organization.
Review the ICD-10 changes below and take advantage of AOA's coding resources.
5 changes to take note
The AOA offers a detailed description of some of the significant code changes impacting optometric practices. Below are five general overviews from the Oct. 1 update. These changes affect coding for:
- Low vision and blindness. More than 50 ICD-10 additions and revisions are related to diagnosis codes for low vision and blindness.
- Degenerative myopia. More than 20 ICD-10 additions and revisions are related to degenerative myopia.
- Diabetes mellitus. Two new codes specify Type 2 diabetes with ketoacidosis with/without coma.
- Injuries of the optic tract and pathways, and visual cortex. Six new code revisions add specificity to existing diagnosis codes to denote "side" of the body rather than "eye" for injuries of the optic tract and pathways, and the visual cortex.
- Mental, behavioral and neurodevelopment disorders. New code additions and revisions are related to reading disorders and attention-deficit hyperactivity disorder (ADHD).
Use the most up-to-date coding resources
With ICD-10's increasing specificity and complexity each year, it's crucial to have a resource that optometric practices can turn to for guidance. That resource is the AOA's Codes for Optometry manual, a comprehensive reference guide that helps professionals learn how to make correct decisions when selecting diagnosis codes, code modifiers and Health Care Common Procedure Coding System codes and modifiers.
Order the newest Codes for Optometry coding bundle today, complete with the AOA's coding manual, as well as the AOA Common Optometric ICD-10 Codes card, 2018 AMA CPT Professional Edition and a digital download of the Codes for Optometry.
Ask the coding experts
If you have any questions regarding Medical Records and Coding, please submit them by using the Coding Experts Submission Form and one of our coding experts will be in contact with you.
Changes in coding and reimbursements worth knowing. Meanwhile, with the clock winding down on 2023, the AOA continues to press for Congress to act on reforms that would give doctors of optometry an annual, permanent inflationary Medicare payment tied to the Medicare Economic Index.
The federal government and private payers are heavily scrutinizing the use of modifier -25. When used appropriately, it can help to ensure that patients receive appropriate treatment and that doctors of optometry are reimbursed appropriately for their service. If you believe a claim that includes modifier -25 was inappropriately denied, follow appropriate criteria when appealing.