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2016 ICD-10 Update
Posted: August 19, 2016

On October 1, 2016, a large number of new ICD-10 codes will go into effect allowing a greater degree of specificity for many conditions that eye care providers frequently manage.  As your partner, we will support your transition to these new codes.  It’s still important, though, that providers educate themselves on the changes to make the transition as easy as possible.

So what are some of the differences that you’ll need to know on October 1?

  1. Many of the updated codes involve diabetic retinopathy, primary open angle glaucoma and macular degeneration.  Thus, if you’re managing a high volume of patients with these conditions, anticipate a high number of conversions that will need to be made.
  2. A large part of the change involves allowing laterality to be assigned to conditions that previously lacked it.  As an example, H40.11X1 was implemented on Oct 1, 2015 to represent “primary open angle glaucoma, mild stage” but the code didn’t allow the provider to specify the affected eye(s).  On Oct 1, 2016, the “X” placeholder will be replaced by a number that will provide those details.
  3. Related to #1 and #2, there won’t be any automatic conversions like there where when we moved from ICD-9 to ICD-10.  That means you won’t look at your system on October 1 and see that H40.11X1 has been automatically converted to a new code.  That’s because an accurate conversion is just not possible without you specifying the affected eye(s).
  4. Coding to the highest level of specificity will become more important.  You’ll recall the leniency that CMS afforded at the time of ICD-10 implementation allowing “unspecified” codes (i.e. H16.209 – unspecified keratoconjunctivitis, unspecified eye) to be accepted provided they were within the proper code family.  While October 1, 2016 hasn’t been announced as an official end to that leniency, the availability of more detailed codes is a step in that direction.  Prepare now by avoiding “unspecified” codes whenever possible.

We are working to make your transition to these new codes as seamless as possible.  In the interim, we’ve created a document and video (both posted below) to facilitate your introduction to the changes.  While there are just shy of 1950 total code updates, the document is filtered to just those that will pertain to most eye care providers. More information on this topic to come soon.

2016 ICD10 Customer Update document






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