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  • Background

    On Oct. 1, 2020, physician practices must adopt new ICD-10-CM codes — approximately 80 new and revised codes for ophthalmologists alone. The updates include:

    • Corneal dystrophies
    • Corneal transplant
    • COVID-19
    • Headache
    • Sickle-cell disorder

    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, 2020, 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.