Except for dystrophies, corneal ICD-10 codes have a digit for laterality:
In these examples, report laterality by replacing the dash with a 1, 2, or 3.
ICD-10’s section for hereditary corneal dystrophies lists 7 conditions. Each has only 1 code; no laterality is needed.
Excludes1 Notes flag conditions that can’t be billed in the same eye at the same patient encounter. For example, M35.01 Sjögren’s syndrome isn’t payable with H16.22 Keratoconjunctivitis sicca. Similarly, H1.21 Acute toxic conjunctivitis is not payable with T26- Burn and corrosion confined to eye and adnexa.
T15.0- Corneal foreign body, T15.1- Conjunctival foreign body, and T26.1- Burn of cornea and conjunctival sac must be submitted as 7-character codes, with the final character being an A (if an initial encounter), D (subsequent encounter), or S (sequela).
A cornea ICD-10 reference guide, along with guides for other subspecialties, can be found at www.aao.org/practice-management/coding/icd-10-cm/resources. Thanks to David B. Glasser, MD, for his contribution to this resource.
As previously, the fifth character of corneal dystrophy’s ICD-10 code (H18.5-) represents the type of dystrophy:
As previously, the sixth character of the ICD-10 code for a corneal transplant (T86.84-) indicates type of transplant:
Further changes that might be relevant to your practice include the following.
While federal payers implemented these codes on Oct. 1 (apart from the two U07 codes, which were implemented earlier), others may be slower to adopt them. You should therefore:
S05.02XD is a billable diagnosis code used to specify a medical diagnosis of injury of conjunctiva and corneal abrasion without foreign body, left eye, subsequent encounter. The code S05.02XD is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.#N#The ICD-10-CM code S05.02XD might also be used to specify conditions or terms like abrasion of left cornea, corneal abrasion, superficial injury of cornea or superficial injury of left eye. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.#N#S05.02X D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like injury of conjunctiva and corneal abrasion without foreign body left eye. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
Your cornea is the outermost layer of your eye. It is clear and shaped like a dome. The cornea helps to shield the rest of the eye from germs, dust, and other harmful matter. It also helps your eye to focus. If you wear contact lenses, they float on top of your corneas.