2017 ICD-10 Updates - Eyefinity

1 2018 ICD- 10 updates In this document: Overview, 1. New ICD-10 Codes Effective October 1, 2017 , 2. Degenerative Myopia, 2. Blindness and Low Vision, 3. ICD-10 Codes Retiring September 30, 2017 , 3. Blindness and Low Vision, 3. ICD-10 Description Modifications Effective October 1, 2017 , 4. Body Mass Index, 4. Trichiasis, 5. Injury of Optic Track and Pathways, 6. Injury of Visual Cortex, 7. Overview CMS is making minor changes to the ICD-10 -CM code set. Although these changes are referred to as the 2018 ICD-10 . update , they are effective October 1, 2017 . In some cases, CMS added new codes and retired others. In other cases, only the description associated with the code changed. Eyefinity software and platforms are prepared to transition to the new codes. 2018 ICD- 10 updates 1.. 2018 ICD- 10 updates New ICD-10 Codes Effective October 1, 2017 . The updated codes apply only to claims with a service date of October 1 or later. Claims with a service date of September 30 or earlier will continue to use the 2017 codes.

2 Billers should familiarize themselves with the changes and be prepared to verify that the correct codes are appearing on claims. Eyefinity has identified 89 ICD-10 changes that apply to eyecare. We anticipate that CMS will modify ICD-10 codes slightly, effective October 1, every year. New ICD-10 This section lists the new eyecare-related ICD-10 codes that are effective October 1, 2017 . Some of the codes may apply Codes Effec- to rare conditions, but are provided here for reference. tive October Degenerative Myopia, 2. 1, 2017 . Blindness and Low Vision, 3. Degenerative Myopia The following codes are effective beginning October 1, 2017 . Description Right Eye Left Eye Bilateral Unspecified With choroidal neovascularization H442A1 H442A2 H442A3 H442A9. With macular hole H442B1 H442B2 H442B3 H442B9. With retinal detachment H442C1 H442C2 H442C3 H442C9. With foveoschisis H442D1 H442D2 H442D3 H442D9. With other maculopathy H442E1 H442E2 H442E3 H442E9.

3 2 2018 ICD- 10 updates 2018 ICD- 10 updates ICD-10 Codes Retiring September 30, 2017 . Blindness and Low Vision The following codes are effective beginning October 1, 2017 . Right Eye Left Eye Left Eye Low Vision Left Eye Blindness Condition Normal Cat 1 Cat 2 Cat 3 Cat 4 Cat 5. Normal vision right eye H5452A1 H5452A2 H5442A3 H5442A4 H5442A5. Low vision right eye category 1 H54511A H542X11 H542X12 H541213 H541214 H541215. Low vision right eye category 2 H54512A H542X21 H542X22 H541223 H541224 H541225. Blindness right eye category 3 H54413A H541131 H541132 H540X33 H540X34 H540X35. Blindness right eye category 4 H54414A H541141 H541142 H540X43 H540X44 H540X45. Blindness right eye category 5 H54415A H541151 H541152 H540X53 H540X54 H540X55. ICD-10 Codes This section lists the eyecare-related ICD-10 codes that will no longer be accepted for services after September 30, 2017 . Retiring Blindness and Low Vision, 3. September 30, 2017 . Blindness and Low Vision The following codes are being retired after September 30, 2017 .

4 The new codes add digits to specify severity. Right Eye Condition Left Eye Normal Left Eye Low Vision Left Eye Blindness Normal vision right eye H5452 H5442. Low vision right eye H5451 H542 H5412. Blindness right eye H5441 H5411 H540. 2018 ICD- 10 updates 3. 2018 ICD- 10 updates ICD-10 Description Modifications Effective October 1, 2017 . ICD-10 This section is informational only. It lists the eyecare-related ICD-10 description modifications that take effect October 1, Description 2017 . These modifications are usually small changes or corrections. The italicized word or words in the right column Modifications highlight the change. Effective Body Mass Index, 4. October 1, Trichiasis, 5. 2017 . Injury of Optic Track and Pathways, 6. Injury of Visual Cortex, 7. Body Mass Index The new description increases the ceiling from 19 to Code Former Description New Description Z681 Body mass index (BMI) 19 or less, adult Body mass index (BMI) or less, adult 4 2018 ICD- 10 updates 2018 ICD- 10 updates ICD-10 Description Modifications Effective October 1, 2017 .

5 Trichiasis The new descriptions correct the spelling of entropion. Code Former Description New Description H02051 Trichiasis without entropian right upper eyelid Trichiasis without entropion right upper eyelid H02052 Trichiasis without entropian right lower eyelid Trichiasis without entropion right lower eyelid H02053 Trichiasis without entropian right eye, unspecified Trichiasis without entropion right eye, unspecified eyelid eyelid H02054 Trichiasis without entropian left upper eyelid Trichiasis without entropion left upper eyelid H02055 Trichiasis without entropian left lower eyelid Trichiasis without entropion left lower eyelid H02056 Trichiasis without entropian left eye, unspecified Trichiasis without entropion left eye, unspecified eyelid eyelid H02059 Trichiasis without entropian unspecified eye, Trichiasis without entropion unspecified eye, unspecified eyelid unspecified eyelid 2018 ICD- 10 updates 5. 2018 ICD- 10 updates ICD-10 Description Modifications Effective October 1, 2017 .

6 Injury of Optic Track and Pathways The new descriptions change the word eye to side. Code Former Description New Description S04031A Injury of optic tract and pathways, right eye, initial Injury of optic tract and pathways, right side, initial encounter encounter S04031D Injury of optic tract and pathways, right eye, Injury of optic tract and pathways, right side, subsequent encounter subsequent encounter S04031S Injury of optic tract and pathways, right eye, sequela Injury of optic tract and pathways, right side, sequela S04032A Injury of optic tract and pathways, left eye, initial Injury of optic tract and pathways, left side, initial encounter encounter S04032D Injury of optic tract and pathways, left eye, Injury of optic tract and pathways, left side, subsequent encounter subsequent encounter S04032S Injury of optic tract and pathways, left eye, sequela Injury of optic tract and pathways, left side, sequela S04039A Injury of optic tract and pathways, unspecified eye, Injury of optic tract and pathways, unspecified side.

7 Initial encounter initial encounter S04039D Injury of optic tract and pathways, unspecified eye, Injury of optic tract and pathways, unspecified side, subsequent encounter subsequent encounter S04039S Injury of optic tract and pathways, unspecified eye, Injury of optic tract and pathways, unspecified side, sequela sequela 6 2018 ICD- 10 updates 2018 ICD- 10 updates ICD-10 Description Modifications Effective October 1, 2017 . Injury of Visual Cortex The new descriptions change the word eye to side. Code Former Description New Description S04041A Injury of visual cortex, right eye, initial encounter Injury of visual cortex, right side, initial encounter S04041D Injury of visual cortex, right eye, subsequent Injury of visual cortex, right side, subsequent encounter encounter S04041S Injury of visual cortex, right eye, sequela Injury of visual cortex, right side, sequela S04042A Injury of visual cortex, left eye, initial encounter Injury of visual cortex, left side, initial encounter S04042D Injury of visual cortex, left eye, subsequent encounter Injury of visual cortex, left side, subsequent encounter S04042S Injury of visual cortex, left eye, sequela Injury of visual cortex, left side, sequela S04049A Injury of visual cortex, unspecified eye, initial Injury of visual cortex, unspecified side, initial encounter encounter S04049D Injury of visual cortex, unspecified eye, subsequent Injury of visual cortex, unspecified side.

8 Subsequent encounter encounter S04049S Injury of visual cortex, unspecified eye, sequela Injury of visual cortex, unspecified side, sequela 2018 ICD- 10 updates 7.