• Coding Top 10: Blepharitis, Complex Cataract Surgery and High-Risk Medications

    Coding Top 10, October 2015

    Ask the Academy Coding Experts is a new online resource for trusted responses to your coding questions.

    The Academy Coding Experts receive daily questions at coding@aao.org and icd10@aao.org. We are committed to providing accurate responses so that practices are confident in their billing and coding practices. We have provided the top 10 questions received for November.

    October's Coding Top 10 questions cover injury-claim exams, diagnosis-code basics and coding ICD-10 for diabetes.

    1. Submitting injury claim exams
      When submitting injury claim exams do we need to report where and how the injury occurred in addition to the injury itself?
    2. How to code diabetes with no ophthalmic disease progression
      What is the best diagnosis code to use when a patient is sent to our practice because they have diabetes, but no ophthalmic disease progression is diagnosed?
    3. Should you report insulin use for patients with diabetes?
      Should we be reporting insulin use Z79.4 for our patients with diabetes?
    4. Coding exams for patients on high-risk medications
      How should we code exams for patients on high-risk medications in ICD-10?
    5. Blepharitis exam reporting: How many lids?
      Blepharitis is reported by lid, not by eye, so must I report all four lids for payment on my exam?
    6. ICD-10 codes for complex cataract surgery
      How can I indicate to the payer that that the cataract surgery was complex?
    7. Modifiers and ICD-10 code laterality
      Are modifiers –RT and –LT still required for CPT codes or is the laterality of ICD-10 sufficient?
    8. Linking ICD-10 codes for bilateral age-related nuclear cataracts
      The patient is diagnosed with bilateral age-related nuclear cataracts. It’s determined that cataract surgery will be performed in the right eye and an A-scan is performed the same day. How should the ICD-10 codes should be linked?
    9. What diagnosis codes should be reported?
      What diagnosis codes should be reported? All that apply to the patient or all that apply to today’s visit?
    10. Are there known billing issues with diagnosis codes H50.2 and H52.0?
      My pediatric ophthalmologist heard claims will be denied because two diagnosis codes are considered mutually exclusive. I could not find any information regarding this on these two diagnosis codes--H50.2 and H52.0. Have you seen or heard of any issues when billing with these two diagnosis codes?