4 7
N O V E M B E R 2 0 1 5 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
or when the IOL was supported by using permanent sutures or a cap-
sular support ring.
Overall, greater specificity will be required to correctly code nearly
every diagnosis and procedure. Let's look at the example of a patient
with a retinal tear in the right eye. If the surgeon repairs the retinal
break using photocoagulations, the CPT code is 67145-RT. But the
type of tear offers several choices:
• H33.311 Horseshoe tear without detachment, right eye
• H33.321 Round hole without detachment,
right eye
• H33.331 Multiple defects without detachment, right eye
Having thorough and detailed op reports is obviously essential in
order for your staff to choose the correct code.
If you still need help
The ICD-10 transition isn't a one-and-done thing. For the first few
months, having an ICD-10 codebook and other resources easily
accessible is imperative for these tricky situations. You'll also find
several free resources on the American Academy of Ophthalmology's
website (aao.org/icd10). Once you start receiving reimbursements and
denials, be sure to closely monitor them for any denial trends —
they may be related to the common problems listed above. OSM
Ms. Vicchrilli (icd@aao.org) is the director of coding and reimbursement for the American Academy of
Ophthalmology. She is the author of EyeNet's "Savvy Coder," the "Ophthalmic Coding Coach Ophthalmic
Coding Series" and the "2016 ICD-10-CM for Ophthalmology: The Complete Reference."
