ICD-10 Coding for Ophthalmology

A New Chapter for Eyes

Betsy Nicoletti, MS


February 21, 2014

In This Article

The Seventh Character

The meaning of the seventh character is not the same in all chapters. In the eye chapter, it denotes the stage of glaucoma. In the injury chapter, it can indicate whether the treating physician is seeing the patient for the first time for this injury or for a subsequent encounter. The seventh character has different meanings for certain types of fractures. External-cause codes, which are equivalent to E codes in ICD-9, are found in chapter 20 and are greatly expanded.

Experienced coders won't find the changes in terminology difficult. Coders are accustomed to changes in codes and rules. Much of ICD-10, such as the general guidelines at the start of the book and the terms and symbols on each page, will seem familiar to coders.

However, the coding system changes completely, from 3-, 4-, and 5-digit codes to codes that could be 3, 4, 5, 6, or 7 digits long. In particular, coders must pay attention to the meaning of the seventh character -- which varies depending on the chapter -- and to the increased specificity in the coding system.

Consult available resources now, code some eye cases, and give specific feedback about what additional documentation will be required for ICD-10. The implementation date will be here soon.


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