The 2021 ICD-10-CM Codes Update Guide for Eye Care
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Is your eye care practice ready for the ICD-10-CM (diagnosis) code changes for fiscal year 2021? There is no need to procrastinate. This 2021 ICD-10-CM Eye-Related Codes Update Guide is here to support your practice and protect your cash flow.
Beginning October 1, 2020, all eye care providers must start using the new and revised ICD-10-CM eye-related codes to prevent delays in optometric claim processing and/or rejected or denied claims later.
Download our 2021 ICD-10-CM Codes Update Guide to start educating coders, billers, and providers now.
What is an ICD-10-CM Diagnosis Code?
The ICD-10-CM (International Classification of Diseases, Tenth Revision) diagnosis code is a medical code that describes the condition and diagnoses of patients, whereas the ICD-10-PCS (procedural classification system) code describes inpatient procedures. A diagnosis code tells the insurance payer why you performed the service.
The World Health Organization (WHO) owns, develops, and distributes ICD codes. In the US, these are divided into ICD-10-CM, or Clinical Modifications, and ICD-10-PCS, or Procedure Coding System.
Each year, the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) publish new, deleted, and modified ICD-10-CM codes.
This year marks the fifth update to ICD-10-CM codes since ICD-10 codes went live on October 1, 2015. The ICD-10-CM code release for fiscal year 2021 includes 72,616 diagnosis codes as compared to 72,184 in 2020.
Check Off These Proactive Tasks for 2021 ICD-10-CM Changes
Lost revenue can devastate a practice. To prevent unhealthy and serious revenue problems down the road, here are proactive billing tips to help you prepare for the 2021 ICD-10-CM code updates.
Review and become familiar with the new, deleted, and revised ophthalmology and optometry billing codes (download our 2021 ICD-10-CM Codes Guide). Claims that have a service date of September 30, 2020, or earlier, must continue to use the current 2020 codes, while claims with a service date of October 1, 2020, or later, must use the new 2021 codes.
If you have a “favorites” list in your ophthalmology or optometry EHR and practice management system, add new codes and remove old codes.
Review plans, assessments, and outbound documents that are mapped from the old codes to the new codes.
Review and update all “code rules” you created in your EHR and practice management software affected by the new and deleted 2021 codes.
Be careful when using “copy from previous” as many ophthalmology and optometry software systems copy over removed codes. Ensure the primary ICD-10-CM codes match the primary chief complaint and reason for the visit in the exam note.
Contact your optometry and ophthalmology associations for specific coding changes and ICD-10 coding resources.
Notable Changes with ICD-10-CM Codes in 2021
There are 490 new, 58 deleted, and 47 revised ICD-10-CM codes for fiscal year 2021. Of these codes, there are 53 new codes, 14 deleted codes, and 5 revised code descriptions for eye-related discharges and patient encounters occurring from October 1, 2020, through September 30, 2021.
ICD-10-CM codes are divided into 22 chapters, and chapters are based on code subjects. Chapter 22 (Codes for Special Purposes, U00-U85) is new this year and only includes two codes: vaping-related disorder (U07.0) and COVID-19 (U07.1).
The 2021 eye-related code updates primarily affect the following four ICD-10-CM chapters.
Chapter 7: Diseases of the eye and adnexa (H00–H59). The new corneal dystrophies and dystrophy codes add one digit to the end of the codes to specify laterality and represent the patient’s condition more accurately. A new code for deficient smooth pursuit eye movements has been added (H55.82), and “deficient” was added to saccadic eye movements (H55.81).
Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00–R99). The new codes add one digit to the end for specificity to code the symptom of the headache.
Chapter 19: Injury, poisoning and certain other consequences of external causes (S00–F88). The new codes add one digit to specify laterality that describes corneal transplant rejection, failure, infection, or complications.
Chapter 20: External causes of morbidity (V00–Y99). The new codes add one digit to the end of the code for specificity for therapeutic (nonsurgical) and rehabilitative ophthalmic devices associated with adverse incidents.
ICD-10 Pro Tip: Before you use an “unspecified” code (especially when it refers to laterality), the examining provider must indicate the affected anatomy.
Get Paid Faster With Fewer Coding Denials
Fast Pay Health certified coders and optometric billing consultants have extensive experience in optometry and ophthalmology coding. Coders are well-versed in CPT® and ICD-10 coding, billing with code modifiers, electronic data interchange (EDI) processes, industry standards, and maintaining 100% HIPAA compliance.
Our optometric billers make sure your claims are scrubbed clean and free from errors before we submit them—decreasing claim denials and delivering a consistent and positive cash flow for your practice.
Be Prepared With This 2021 ICD-10-CM Code Updates Guide
Ready to make the transition from 2020 codes to the new 2021 ICD-10-CM codes easier? Our 2021 Eye-Related Codes Update Guide includes a list of codes and descriptions for new (added), deleted (retired), and revised (modified descriptions) codes. We also added a list of ICD-10 industry resources. Download the guide now.
