Dry macular degeneration is characterized by the presence of yellow deposits, called drusen, in the macula. Macular degeneration generally starts in the dry form and is classified to ICD-9-CM code 362.51.Mar 5, 2007
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AnswerWhat is the ICD 10 code for drusen (degenerative) of macula?
H35.363 is a valid billable ICD-10 diagnosis code for Drusen (degenerative) of macula, bilateral . 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 . ICD-10 code H35.363 is based on the following Tabular structure:
What is the ICD-10 code for bilateral drusen?
Question: Patient has bilateral drusen and we performed bilateral fluorescein angiographies. ICD-10 lists drusen as right, left or both eyes. How do we submit the tests? A single line item 92235-50 and H35.363 Dursen (degenerative) of macula, bilateral.
What is the treatment code for dry macular degeneration?
The treatment code should indicate which eye is being treated. The codes for dry AMD—H35.31xx—use the seventh character to indicate staging as follows: H35.31x1 for early dry AMD —a combination of multiple small drusen (≤ 63 μm), few intermediate drusen (> 63 μm and ≤ 124 μm), or retinal pigment epithelium (RPE) abnormalities.
Does drusen affect the macula?
Drusen consist of protein and lipids (fat). Although not likely to affect the macula, drusen may increase the risk of dry age-related macular degeneration (AMD), a disease that affects a person's central vision. 2
Coding for Laterality in AMD
When you use the codes for dry AMD (H35.31xx) and wet AMD (H35.32xx), you must use the sixth character to indicate laterality as follows:
Coding for Staging in Dry AMD
The codes for dry AMD—H35.31xx—use the seventh character to indicate staging as follows:
Defining Geographic Atrophy
When is the retina considered atrophic? The Academy Preferred Practice Pattern1 defines GA as follows:
Coding for Geographic Atrophy
The Academy recommends that when coding, you indicate whether the GA involves the center of the fovea: Code H35.31x4 if it does and H35.31x3 if it doesn’t, with “x” indicating laterality.
Coding for Staging in Wet AMD
The codes for wet AMD—H35.32xx—use the sixth character to indicate laterality and the seventh character to indicate staging as follows:
Focus on Payment Policy at AAO 2017
Introduction to Physician Payment Policy (Sym12). A panel will explain how new CPT codes are created and valued; how existing codes are targeted for reevaluation; the impact of new technology on the valuation of existing procedures; and the difference between CMS and commercial carrier coverage policies. When: Sunday, Nov. 12, 11:15 a.m.-12:15 p.m.
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