• Coding Top 10: Routine Exams, Encounter Status and Macular Edema


    Coding Top 10, November 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.

    This November's coding questions cover several subspecialties, from glaucoma to retina, and topics from routine eye exams to how to apply encounter status in cases of injury or trauma.

    1. Injury and trama cases: applying encounter status 
      When should I use the required A vs. D in the seventh position for ICD-10 when caring for patients with injury or trauma? I’ve heard varying opinions on this.

    2. ICD-10 code for visual complaint after cataract surgery
      I will perform either CPT code 66986 IOL exchange or possibly CPT code 66985 Piggyback IOL on a patient who has negative dysphotopsia (defined as a visual complaint after cataract surgery). The patient describes this as a persistent dark temporal crescent. What ICD-10 code or codes for these procedures?

    3. Billing routine exam ICD-10 codes
      When would it be appropriate to use Z01.01 (routine eye exam with abnormal findings) instead of Z01.00 (routine eye exam without abnormal findings); would that include refractive disorders such as myopia?

    4. ICD-10 code for a neoplasm of uncertain behavior of the eyelid
      What is the appropriate code for a neoplasm of uncertain behavior of the eyelid?

    5. ICD-10 code for superior limbic keratoconjunctivitis
      What is the ICD-10 code for superior limbic keratoconjunctivitis?

    6. ICD-10 code for cystoid macular edema 
      What is the ICD-10 code for cystoid macular edema? All we can locate is cystoid macular edema following cataract surgery (H59.03-).

    7. ICD-10 code for macular edema with no diabetes 
      What the best code for straight macular edema with no diabetes?

    8. ICD-10 code for posterior uveitis 
      How do I "crosswalk" ICD-9 code 363.20 Posterior uveitis to ICD-10?

    9. ICD-10 code for status post vitrectomy surgery 
      Is there an ICD-10 code for status post vitrectomy surgery? Of the ones I have looked at, none pertain to retina.

    10. Staging definitions for glaucoma 
      Where do I find the staging definitions for glaucoma?