2024 ICD-10-CM Code Updates Guide for Eye Care
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Is your office prepared for the fiscal year (FY) 2024 eye-related ICD-10-CM code changes that become effective on October 1, 2023? These ICD-10-CM code updates include new diagnosis codes that all eye care providers must use when submitting claims to Medicare, Medicaid, and other insurance payers.
Why is it so important to pay attention to using the correct codes? Well, the consequences of not doing so can be dire. Picture this: delays, rejections, and denials of your claims.
To help you navigate these FY 2024 code updates, we've prepared a quick guide to the eye-related ICD-10-CM code changes for October 1, 2023 through September 30, 2024.
What is an ICD-10-CM Diagnosis Code?
The World Health Organization (WHO) owns, develops, and distributes ICD (International Classification of Diseases) codes. The U.S. codes include ICD-10-CM (Clinical Modifications) and ICD-10-PCS (Procedure Coding System).
ICD-10-CM codes are updated annually to reflect the latest scientific and clinical knowledge.
ICD-10-CM codes are divided into 22 chapters, and chapters are based on code subjects.
An ICD-10-CM diagnosis code tells the insurance payer why you performed the service, whereas an ICD-10-PCS code describes inpatient procedures.
What Are the Eye-Related ICD-10-CM Codes in 2024?
Chapter 7, Diseases of the Eye and Adnexa, has 34 additions and one deletion (retired). The new codes include non-proliferative/proliferative sickle-cell retinopathy, extraocular eye muscle entrapment, and foreign body sensation. In addition, the new codes add one or more digits to the end to specify laterality.
Sickle-Cell Retinopathy (9 new codes)
Muscle Entrapment (21 new codes)
Foreign Body Sensation (4 new codes)
Retinal Disorders (1 retired code)
Updating Your ICD-10-CM Codes for 2024 Checklist
Lost revenue can devastate an eye care practice. To ensure a smooth transition to the 2024 ICD-10-CM new codes, you should take the following steps to prevent denied claims and ensure a smooth billing process.
Educate your staff about the new codes. Review and become familiar with the new, deleted, and revised ophthalmology and optometry billing codes. Claims with a service date of September 30, 2023, or earlier must continue to use the 2023 ICD-10-CM eye-related codes, while claims with a service date of October 1, 2023, or later must use the new 2024 codes.
Add new codes and remove old codes. Update codes if you have a “favorites” list in your ophthalmology or optometry EHR and practice management system.
Confirm with your EHR software vendor that they provide automatic ICD-10 updates. For instance, MaximEyes EHR and practice management software will automatically start using the new 2024 ICD-10-CM codes on October 1, 2023. 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 in your EHR that are mapped from the old codes to the new ones.
Review and update all “code rules” you created in your EHR and practice management software affected by the new and deleted 2024 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.
ICD-10-CM Codes Industry Resources
2024 ICD-10-CM Code Files (cms.gov)
ICD-10-CM Official Guidelines for Coding and Reporting (cdc.gov)
Health Insurance Claim Form (nucc.org)
2024 ICD-10-CM Code Books (AAPC)
How to Get Paid Faster with Fewer Coding Denials
Fast Pay Health optometric billing specialists 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 enjoy the advantages of cleaner claims that focus on improving your eye care practice’s financial health.
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