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  • Glaucoma ICD-10 Ask the Expert

    Coding Low- and High-Risk Glaucoma Suspect


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    Question: Our LCD policy no longer allows for glaucoma suspect unspecified. It only allows for low or high risk.  How do we determine the appropriate code?

    Answer: The physician will determine if the patient is low- or high-risk. This is included on the ICD-10 quick reference guide for glaucoma codes.

    Risk Factors for OAG Suspect Codes:

    • African American or Hispanic race
    • Family history of glaucoma in first-degree relative
    • Thin central corneal thickness
    • High IOP
    • Pseudoexfoliation or pigment dispersion syndrome

    ≥ 3 risk factors = high risk  

    ≤ 2 risk factors = low risk

    Learn more about coding diagnoses in ICD-10-CM for Ophthalmology: The Complete Reference.