• Coding Top 10: How to Code the Appropriate ROP Stage, Excludes1 Edits for Strabismus Amblyopia and ICD-10 Code for TORCH


    Coding Top 10, March 2016

    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 pediatric/strabismus questions received for March.

    March's coding questions highlight the pediatric/strabismus subspecialty with topics ranging from how to code the appropriate ROP stage to Excludes1 edits for Strabismus Amblyopia.

    1.  ICD-10 Code for Failed Vision Screening
      The pediatric ophthalmologists in our practice see a lot of kids for failed vision screenings who are often not yet verbal. In ICD-9, doctors used visual-disturbances codes like 368.1, 368.8, 368.9 for patients like this. What code should we use in ICD-10?

    2. Diagnosis Change From Referring Pediatrician
      We saw a patient at the request of a pediatrician and our exam diagnosis code doesn’t match theirs. Should I be concerned about this?

    3. ICD-10 Code for TORCH
      I often get called to the NICU to rule out TORCH infections. What is the best (and hopefully reimbursable) ICD-10 code to use for this?

    4. Should You Code Worst or Current Stage of ROP?
      Initially the baby was retinopathy of prematurity stage 3, but after an injection is now stage 2. Do you code the worst stage the patient has ever had or the current stage?

    5. ICD-10 Code for Conjunctivitis
      What are the ICD-10 options for conjunctivitis?

    6. Best ICD-10 Code for Pseudostabismus
      Is there a problem submitting H50.00 Unspecified esotropia for pseudostrabismus?

    7. How to Code for Infant Nasal Lacrimal Duct Obstruction
      Depending upon the payer, we receive denials for infants with nasal lacrimal duct obstruction. Is there one ICD-10 code that fits all payers’ requirements?

    8. Appropriate Diagnosis When No Ophthalmic Findings
      When you are asked to see an infant for suspected shaken baby syndrome and there are no findings, what diagnosis code should you report?

    9. Excludes1 Edits for Strabismic Amblyopia
      An Excludes1 edit in ICD-10 implies H53.03- Strabismic amblyopia can’t be billed to the same patient, same exam as any H50.-Strabismus diagnosis. Is that truly the case?

    10. ICD-10 Code For Epiblepharon
      What ICD-10 code should we use for epiblepharon?