Cataract (lens) fragments in eye following cataract surgery, bilateral *Note: When reporting ICD-10 code H40.89, one of the following codes must also be reported: H25.21, H25.22 or H25.23.
According to ICD-10-CM, there are close to 70— ranging from age-related to zonular cataracts. Reporting laterality. For some codes, you include a number to indicate laterality: 1 for the right eye, 2 for the left eye, and 3 for both eyes.
Information provided by our coding experts is copyrighted by the American Academy of Ophthalmology and intended for individual practice use only. Question: How can I indicate to the payer that the cataract surgery was complex? Answer: The best way is to choose the appropriate ICD-10 code.
How many different types of cataracts are there? According to ICD-10-CM, there are close to 70— ranging from age-related to zonular cataracts. Reporting laterality. For some codes, you include a number to indicate laterality: 1 for the right eye, 2 for the left eye, and 3 for both eyes.
A complicated cataract refers to the opacification of the crystalline lens secondary to intraocular diseases, mainly intraocular inflammatory conditions that include anterior, intermediate, or posterior uveitis.
Z98. 4 - Cataract extraction status. ICD-10-CM.
Cataract extraction status, unspecified eye Z98. 49 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z98. 49 became effective on October 1, 2021.
9: Cataract, unspecified.
CPT defines the code 66982 as: "Extracapsular cataract extraction removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery ...
For CPT code 66982 and 66987, complex cataract extraction, to be reasonable and necessary, the procedure should require devices or techniques not generally used in routine cataract surgery.
Other specified postprocedural statesICD-10 code Z98. 890 for Other specified postprocedural states is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Age-related nuclear cataract, left eye H25. 12 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM H25. 12 became effective on October 1, 2021.
After the optometrist has seen the patient for post-operative care, he/she will submit a claim for the post- operative care provided, using the appropriate CPT Code, i.e, 66984, and Modifier 55.
ICD-10 code H26. 9 for Unspecified cataract is a medical classification as listed by WHO under the range - Diseases of the eye and adnexa .
H25. 13 Age-related nuclear cataract, bilateral - ICD-10-CM Diagnosis Codes.
A condition in which the lens of the eye becomes cloudy. Symptoms include blurred, cloudy, or double vision; sensitivity to light; and difficulty seeing at night. Without treatment, cataracts can cause blindness.
ICD-10 code H25. 812 for Combined forms of age-related cataract, left eye is a medical classification as listed by WHO under the range - Diseases of the eye and adnexa .
66984—Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation. Many of the nasal/sinus endoscopy codes were modified slightly.
CPT code 92136: ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation.
ICD-10-CM Diagnosis Code H27 129 Anterior dislocation of lens, unspecified eye...
How many different types of cataracts are there? According to ICD-10-CM, there are close to 70 — ranging from age-related to zonular cataracts.
When you submit CPT code 66982, local coverage determinations (LCDs) require more than the traditional cataract diagnosis codes. To indicate why the surgery qualifies as complex, you also must report one of the following codes:
Cataract extraction status, right eye 1 Z98.41 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 The 2021 edition of ICD-10-CM Z98.41 became effective on October 1, 2020. 3 This is the American ICD-10-CM version of Z98.41 - other international versions of ICD-10 Z98.41 may differ.
The 2022 edition of ICD-10-CM Z98.41 became effective on October 1, 2021.
H59.091 is a valid billable ICD-10 diagnosis code for Other disorders of the right eye following cataract surgery . It is found in the 2021 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2020 - Sep 30, 2021 .
Category H59: Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified
The following ICD-10-CM codes support medical necessity and provide coverage for CPT codes: 66982 and 66987.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.
Billing and Coding articles provide guidance for the related Local Coverage Determination (LCD) and assist providers in submitting correct claims for payment. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. The code lists in the article help explain which services (procedures) the related LCD applies to, the diagnosis codes for which the service is covered, or for which the service is not considered reasonable and necessary and therefore not covered.
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. American Medical Association. All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the American Medical Association (AMA).
When one or more concomitant ocular diseases are present that potentially affect visual function (e.g., macular degeneration or diabetic retinopathy), the attestation should indicate that cataract is believed to be significantly contributing to the patient’s visual impairment.
A statement that the patient desires surgical correction, that the risks, benefits, and alternatives have been explained, and that a reasonable expectation exists that lens surgery will significantly improve both the visual and functional status of the patient.
An appropriate preoperative ophthalmologic evaluation, which generally includes a comprehensive ophthalmologic exam (or its equivalent components occurring over a series of visits). Certain examination components may be appropriately excluded based on the specific condition and/or urgency of surgical intervention.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. American Medical Association. All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the American Medical Association (AMA).
Every complex cataract surgery must have a justification to meet the requirements of its CPT descriptor. Therefore, it is strongly recommended to include an initial supporting statement in the operative note. For example:
For example, the presence of "pseudoexfoliation syndrome," which is known to predispose to weaker lens zonules and thus to an increased risk for loss of capsular support for an intraocular lens, would not be sufficient if the zonular support ended up being adequate and no special tools or techniques were employed during surgery. Similarly, a particularly dense cataract that required extra surgical time to address would not qualify.
Below is a list of common ICD-10 codes for Ophthalmology. This list of codes offers a great way to become more familiar with your most-used codes, but it's not meant to be comprehensive. If you'd like to build and manage your own custom lists, check out the Code Search!
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The case involved multiple medical conditions and procedures is properly coded as Diagnosis Codes 366.16 (cataract) and 365.10 (glaucoma) and CPT Codes 66982-RT (right eye complex cataract surgery) and 66180-RT (right eye revision of an aqueous shunt/Aquaflo prosthesis).
A partial-thickness corneal incision was made at the temporal limbus with a keratome blade, and this blade was used to enter the anterior chamber. An anterior capsulotomy was performed with the cystotome in a continuous-tear circular capsulorhexis fashion. BSS was used to hydrodelineate the lens' nucleus. The lens' nucleus was dispersed with the phacoemulsification unit from Alcon, Model 20000.
CPT Code 66982 covers cataract cases for pediatric patients, those with prior eye disease, and cases that require extraordinary techniques and instruments. To qualify the case as complicated, the operative report must clearly document that one or more of these clinical conditions are present.
If you don't document CPT Code 66982 adequately, you will not be reimbursed appropriately. Properly coded complex cataract cases are reimbursed at about $176 more than uncomplicated cataract cases.