The 2020 ICD-10-CM Codes Guide for Eye Care Professionals


2020 is right around the corner. You know what that means... another round of updated ICD-10-CM codes is upon us. These code changes will become effective on October 1, 2019. Your staff needs to know exactly which eye care diagnosis codes were added and deleted for fiscal year 2020.

A denied or rejected claim is lost or delayed revenue for your eye care practice. Now is the time to educate your coders, billers, and providers to stay on track. There is no need to procrastinate—this 2020 ICD-10-CM Codes Guide is here to support your practice and protect your revenue.

An ICD-10-CM Definition for Eye Care Professionals

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 World Health Organization (WHO) owns, develops and publishes ICD codes. The 2020 code changes are the fourth mandated update to ICD-10-CM codes since the switch from ICD-9 to ICD-10 went live on October 1, 2015.

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.

Prepare Your Staff for Updated ICD-10-CM Codes

Preparation is a critical step in your action plan. The following pro tips will help your staff prepare for upcoming ICD-10-CM code updates so your practice is set up for success.

  1. Review and become familiar with the new codes for optometric billing (download our 2020 ICD-10-CM codes update guide). For all claims that have a service date of September 30, 2019, or earlier, you must use the 2019 codes or your claim will get rejected or denied.

  2. Add new codes and remove the old codes in your “favorites” list (optional).
    Most eye care EHR systems include default plans and assessments that are preloaded. Review and modify your plans, assessments, and outbound documents that were mapped from the old 2019 codes to new 2020 codes.

  3. Review and update all “code rules” you created in your EHR and practice management software that are affected by the new and deleted 2020 codes.

  4. Be careful when using “copy from previous” as many optometry software systems will copy over removed codes. Check that the primary ICD-10 codes match the primary chief complaint and reason for the visit in the exam note.

  5. Contact your optometry and ophthalmology industry associations for specific coding changes and ICD-10 coding resources. Listed below are a few resources to get you started.

What’s New for 2020 ICD-10-CM Codes?

The ICD-10-CM 2020 fiscal year code release includes 72,184 diagnosis codes as compared to 71,932 in 2019. 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-specific 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 eye-specific code changes affect the following four 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): Ehlers-Danlos syndrome (EDS) was replaced 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

Ready to make the transition from 2019 codes to the new 2020 ICD-10-CM codes easier? Download the 2020 Eye Care ICD-10-CM Codes Guide to see the 68 new and 5 deleted eye-specific codes, as well as a list of ICD-10 industry resources.