2022 ICD-10-CM Codes Update Guide for Eye Care

Is your practice ready for the ICD-10-CM (diagnosis) code changes for fiscal year (FY) 2022? Beginning October 1, 2021, all eye care providers must start using the new and revised ICD-10-CM 2022 codes to prevent delays in optometric claim processing and/or rejected or denied claims. Here's a quick guide to eye-related code updates for FY 2022.

What is an ICD-10-CM Diagnosis Code?

The World Health Organization (WHO) owns, develops, and distributes ICD codes. In the US, these codes are divided into ICD-10-CM (Clinical Modifications) and ICD-10-PCS (Procedure Coding System).

This year marks the sixth update to ICD-10-CM codes since ICD-10 codes went live on October 1, 2015. The Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) typically publish new, deleted, and revised ICD-10-CM codes each year, which are always effective starting October 1.

ICD-10-CM codes are divided into 22 chapters, and chapters are based on code subjects. The ICD-10-CM diagnosis code is a medical code that describes the condition and diagnoses of patients.

An ICD-10-CM diagnosis code tells the insurance payer why you performed the service; whereas, an ICD-10-PCS code describes inpatient procedures.

Be Proactive With These ICD-10-CM Code Update Tasks

Lost revenue can devastate an eye care practice. Here are proactive medical billing tips to help you stay on track with the 2022 ICD-10-CM code updates to prevent denied claims and serious revenue problems down the road.

• Review and become familiar with the new, deleted, and revised ophthalmology and optometry billing codes. Claims with a service date of September 30, 2021, or earlier must continue to use the 2021 ICD-10-CM eye-related codes, while claims with a service date of October 1, 2021, or later must use the new 2022 ICD-10-CM codes (shown below).

• Add new codes and remove old codes if you have a “favorites” list in your ophthalmology or optometry EHR and practice management system.

• Confirm with your optometry software that they provide automatic ICD-10 updates. For instance, MaximEyes EHR and practice management software will automatically start using the new 2022 ICD-10-CM codes on October 1, 2021. MaximEyes includes a keyword-searchable database that helps you find codes without committing them to memory. You can easily find and select ICD-10 codes with an intuitive ICD Code Selection Tool that prompts you for coding modifiers if you forget any.

• 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 2022 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.

What Changed With Eye-Related ICD-10-CM Codes in 2022?

The following eye-related ICD-10-CM updates will become effective on October 1, 2021.

NEW Codes: Chapter 13 – Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)

REVISED Codes: Chapter 13 – Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)

ICD-10 Pro Tip: Before using an “unspecified” code (especially when it refers to laterality), the examining provider must indicate the affected anatomy. Unspecified codes are used when medical record information is not sufficient to assign a specific code.

NEW Codes: Chapter 22 – Codes for Special Purposes

Industry Resources: ICD-10-CM Codes

• 2022 ICD-10-CM Code Files (cms.gov)

• ICD-10-CM Official Guidelines for Coding and Reporting (cdc.gov)

• ICD-10-CM Web-based Browser Tool (cdc.gov)

• FY 2022 ICD-10-CM Codes Now Available (ICD10Monitor.com)

• Health Insurance Claim Form (nucc.org)

• ICD-10-CM 2022: The Complete Official Code Book (medicalcodingbooks.com)

• 2022 ICD-10-CM Expert for Physicians with Guidelines (optom360coding.com)

• 2022 ICD-10-CM Code Books (AAPC)

• AOA Marketplace (American Optometric Association)

• Academy Store (American Academy of Ophthalmology)

Get Paid Faster with Fewer Coding Denials

Fast Pay Health certified coders and optometric billing consultants have extensive experience in medical billing and revenue cycle management (RCM) processes. 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.

Request a free practice analysis today and start enjoying the advantages of cleaner claims that focus on improving your eye care practice’s financial health.

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