ICD-10-CM Codes Guide: 2020 Updates for Eye Care Practices

ICD-10-CM Success

ICD-10-CM Codes Guide: 2020 Updates for Eye Care Practices

Is your eye care practice preparing for the 2020 ICD-10-CM code changes? Do you know what eye-related diagnosis codes were added and deleted for fiscal year 2020?

2020 ICD-10-CM codes come into effect on October 1, 2019. Don’t wait until the last minute to review updated ICD-10-CM codes. Use this ICD-10-CM Codes Guide to start educating coders, billers, and providers now—so you can avoid delays in claim processing and/or rejected or denied claims later.

ICD-10-CM 2020 Updates Guide

What is ICD-10-CM?

ICD-10-CM is a medical code that describes the condition and diagnoses of patients, whereas the ICD-10-PCS code describes inpatient procedures. A diagnosis code tells the insurance payer why you performed the service.

The World Health Organization (WHO) owns, develops, and publishes ICD codes. On June 21, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) released the International Classification of Diseases, Tenth Edition (ICD-10-CM) code changes for 2020.

The 2020 ICD-10-CM code changes are the fourth mandated updates to the codes since the move from ICD-9 to ICD-10 went live on October 1, 2015. The ICD-10-CM 2020 fiscal year code release includes 72,184 diagnosis codes as compared to 71,932 in 2019. While that’s still a lot of codes, each year more codes are being invalidated (deleted).

How To Prepare for 2020 Eye Care ICD-10-CM Codes

How can you jump-start your optometric billing and coding before October 1, 2019? Here are 6 things to start doing now to stay on track.

  1. Review and become familiar with the new codes (download our 2020 Eye Care ICD-10-CM Codes guide) for optometry and ophthalmology billing. Claims that have a service date of September 30, 2019, or earlier, must include the 2019 codes to avoid a rejected or denied claim, while claims with a service date of October 1, 2019, or later, must use the new 2020 codes.
  2. If you have a “favorites” list in your EHR or practice management system, add new codes and remove the old codes.
  3. Review plans, assessments, and outbound documents in your ophthalmology or optometry software that were mapped from the old codes to the new codes.
  4. Review and update all “code rules” you created in your EHR and practice management software that need to change from the new and deleted 2020 codes.
  5. Be careful when using “copy from previous” as many ophthalmology and optometry software systems will copy over removed codes. Make sure the primary ICD-10 codes match the primary chief complaint and reason for the visit in the exam note.
  6. Check with your optometry (AOA.org) and ophthalmology (AAO.org) industry associations for specific coding changes and ICD-10 coding resources.

What Changed in 2020 for ICD-10-CM Codes?

Overall, for 2020, there are 273 new codes, 30 revised code descriptions, and 21 deleted codes. Of the new, revised and deleted codes, there are 68 new codes and 5 deleted codes for eye-related discharges and patient encounters occurring from October 1, 2019, through September 30, 2020.

ICD-10-CM codes are divided into 21 chapters, and codes are based on code subjects. The 2020 code updates affect the following four ICD-10-CM chapters.

  • Chapter 8: Disease of the Ear and Mastoid Process (H60–H95). Removed ear references and made H81.4 (Vertigo of central origin) a reportable code; codes H81.41-49 (central nervous system origin) were deleted.
  • Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00–Q99). Replaced Ehlers-Danlos syndrome (EDS) with new five-character options to indicate common and severe types of EDS.
  • Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00–T88). New subcategories specify fractures of the orbital roof and individual orbital walls often seen in facial trauma cases.
  • Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00–Z99). Two new codes were added for an encounter following a failed exam.

Be Prepared With Our 2020 ICD-10-CM Codes Guide

The 2020 Eye Care ICD-10-CM Codes Guide includes the 68 new and 5 deleted eye-related codes. A bonus list of ICD-10 industry resources is included as well. Make your 2020 transition easier by downloading the guide.

ICD-10-CM Codes Update Guide