• Background

    On Oct. 1, 2019, physician practices must adopt new ICD-10 codes — approximately 70 new codes for ophthalmologists alone. The updates change impact:

    • Failed vision screening
    • Orbital floor fractures
    • Medical and lateral wall fractures
    • Congenital malformations

    The Academy helped you transition to ICD-10 successfully. We’ll lead you to equal success in adopting these updated diagnosis codes.

    What You Need to Know

    • Medicare: For all claims with dates of service on or after Oct. 1, 2019, you must use the updated ICD-10 codes. If you do not, CMS might reject all claims. Always confirm with your MAC for updated local coverage determination policies (LCDs). No ICD-10 changes impact National Coverage Determination policies (NCDs).
    • Commercial payers: Some may take longer to update codes. This could result in claims denials and payment delays of a month or more.
    • Merit-Based Incentive Payment System: The new ICD-10 codes currently do not affect MIPS reporting.