icd 10 code for glaucome suspect

What is the ICD-10 code for glaucoma suspect?

Although 304 ICD-10 codes contain the word glaucoma, only one exists for glaucoma suspect (H40.0). Yet, it’s not a proper code to use for diagnosis or for submitting to a carrier because it lacks specificity.

How do we determine the appropriate OAG code for glaucoma?

It only allows for low or high risk. How do we determine the appropriate code? Answer: The physician will determine if the patient is low- or high-risk. This is included on the ICD-10 quick reference guide for glaucoma codes. Risk Factors for OAG Suspect Codes:

What are the H40 levels of glaucoma?

Glaucoma H40- > 1 H40.0 Glaucoma suspect. 2 H40.1 Open-angle glaucoma. 3 H40.2 Primary angle-closure glaucoma. 4 H40.3 Glaucoma secondary to eye trauma. 5 H40.4 Glaucoma secondary to eye inflammation. 6 H40.5 Glaucoma secondary to other eye disorders. 7 H40.6 Glaucoma secondary to drugs. 8 H40.8 Other glaucoma. 9 H40.9 Unspecified glaucoma.

What is the ICD 10 code for eye injury?

H40.0 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. The 2022 edition of ICD-10-CM H40.0 became effective on October 1, 2021. This is the American ICD-10-CM version of H40.0 - other international versions of ICD-10 H40.0 may differ. injury (trauma) of eye and orbit ( S05.-)

Is glaucoma suspect a diagnosis?

Abstract. Glaucoma suspect is a diagnosis reserved for individuals who do not definitively have glaucoma at the present time but have characteristics suggesting that they are at high risk of developing the disease in the future based on a variety of factors.

What is the ICD-10 code for borderline glaucoma?

ICD-10-CM Code for Open angle with borderline findings, low risk, unspecified eye H40. 019.

What is the difference between glaucoma suspect and glaucoma?

A glaucoma "suspect” is an individual who demonstrates one or more factors that put them at higher risk of a glaucoma diagnosis, but do not yet have glaucoma damage. Sometimes this is referred to as pre-glaucoma or borderline glaucoma.

What does glaucoma suspect mean?

A glaucoma suspect is defined as a person who has one or more clinical features and/or risk factors which increase the possibility of developing glaucomatous optic nerve degeneration (GOND) and visual deficiency in the future.

How is a glaucoma stage reported in ICD-10?

Moderate stage glaucoma is noted with a “2” as the final digit in the diagnosis code. As in the example above, moderate stage open angle glaucoma with borderline findings and low risk the ICD-10 code would be H40. 011X2 for the right eye and H40. 012X2 for the left eye.

What is the category code for glaucoma?

H40. 10X3, unspecified open-angle glaucoma, severe stage. H40. 10X4, unspecified open-angle glaucoma, indeterminate stage.

What is narrow angle glaucoma suspect?

'Primary angle closure suspect' (Often referred to as 'anatomical narrow angle') refers to when an eye with narrow angles without evidence of glaucoma. These patients will still need to be monitored for the development of glaucoma in their lifetime.

What are signs of glaucoma suspect?

What are the signs of a glaucoma suspect?Elevated intraocular pressure (above normal values)Strong history of glaucoma in the family.Optic nerve has a suspicious appearance.Aging.Ethnic background (African-American or Hispanic)Corticosteroid use, especially eye drops.More items...

What is the criteria for diagnosing glaucoma?

If it is not possible to examine the optic disc, glaucoma is diagnosed if: (A) The visual acuity <3/60 and the IOP >99.5th percentile, or(B) The visual acuity <3/60 and the eye shows evidence of glaucoma filtering surgery, or medical records were available confirming glaucomatous visual morbidity.

What is a pre glaucoma condition?

What is pre-glaucoma? Pre-glaucoma is a term used for patients with ocular hypertension (persons with elevated intraocular pressure but no detectable disc or visual field damage), and patients with large cup/disc ratios and normal visual fields who may or may not have early normal-tension glaucoma.

What is considered borderline glaucoma?

For mild or borderline glaucoma—meaning an optic nerve that looks somewhat suspicious but still functions—your doctor may want to monitor you indefinitely, until the condition changes or worsens, and then begin treatment. Doctors use the term “glaucoma suspect” to describe people with borderline findings.

What does OU mean for eyes?

They are Latin abbreviations: OS (oculus sinister) means the left eye and OD (oculus dextrus) means the right eye. Occasionally, you will see a notation for OU, which means something involving both eyes.

What percent of glaucoma suspects develop glaucoma?

Glaucoma Outlook Most people who are glaucoma suspected do not develop optic nerve damage and/or vision loss. Overall, about 1% of individuals with OHT develop glaucoma per year. The risk is higher for people who have additional risk factors besides elevated IOP.

How many types of glaucoma are there?

There are many ways to classify glaucoma, but there are generally four categories or types of glaucoma. The four types are Primary Open Angle Glaucoma, Angle Closure Glaucoma, Normal Tension Glaucoma, and Secondary Glaucoma.

Can borderline glaucoma be reversed?

The damage caused by glaucoma can't be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if you catch the disease in its early stages.

What is considered borderline glaucoma?

For mild or borderline glaucoma—meaning an optic nerve that looks somewhat suspicious but still functions—your doctor may want to monitor you indefinitely, until the condition changes or worsens, and then begin treatment. Doctors use the term “glaucoma suspect” to describe people with borderline findings.

What is H40.0 code?

H40.0 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of glaucoma suspect. The code is not specific and is NOT valid for the year 2021 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes ...

Can glaucoma cause blindness?

Glaucoma is a group of diseases that can damage the eye's optic nerve. It is a leading cause of blindness in the United States. It usually happens when the fluid pressure inside the eyes slowly rises, damaging the optic nerve. Often there are no symptoms at first. Without treatment, people with glaucoma will slowly lose their peripheral, or side vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains.

What is considered a diagnostic test for a patient at risk?

The diagnostic testing associated with a patient at risk, but not diagnosed, includes gonioscopy , pachymetry, tonometry, perimetry, careful optic nerve observation and ocular imaging. The term “ocular imaging” can include fundus photography and OCT based on the specific medical necessity of the patient.

How many OCTs are allowed per year?

The frequency of testing is now based on two criteria: the patient’s condition and the insurance carrier’s guidelines. Most carriers allow one to two OCTs per year, generally alternated with a visual field. For stereoscopic photos, clinicians must establish necessity in the medical record each time they take a photo.

When to use ICD-10 code for glaucoma?

Once the clinician establishes the diagnosis—whether a specific form of glaucoma or simply at risk—they then use that ICD-10 code on subsequent visits when performing follow-up tests to monitor progress and treatment effect.

Is 304 a proper diagnosis code?

Setting a Diagnosis. Although 304 ICD-10 codes contain the word glaucoma, only one exists for glaucoma suspect (H40.0). Yet, it’s not a proper code to use for diagnosis or for submitting to a carrier because it lacks specificity.