Documenting Different Types of Glaucoma – Know the Related ICD-10 Codes

1. Documenting Different Types of Glaucoma – Know the Related ICD-10 Codes Glaucoma is a group of eye conditions that damage the optic nerve which connects the eye to the brain. Read about its ICD-10 codes. Glaucoma is a group of eye diseases that damage the optic nerve which connects the eye to the brain. The condition usually happens when fluid builds up in the front part of your eye. The extra fluid buildup increases the pressure in the eyes, damaging the optic nerve. Unless this pressure is brought down and controlled, the optic nerve and other parts of the eyes may become damaged, leading to partial loss of vision or blindness. Regarded as one of the leading causes of irreversible blindness, the disease usually affects both eyes, even though one may be more severely affected than the others. Glaucoma is also called the "silent thief of sight," as most of its types typically cause no pain and produce no symptoms until noticeable vision loss occurs. For this reason, glaucoma often progresses undetected until the optic nerve already has been irreversibly damaged and vision loss cannot be recovered. Therefore, it is important to conduct regular eye exams that include measurement of eye pressure. Regular eye exams help in identifying the condition in its early stages so that appropriate treatment can be initiated to slow/prevent the progression of the eye disease. Ophthalmologists offering treatment for different forms of glaucoma need to ensure that the medical billing and coding for the same is done appropriately on their medical claims. Outsourcing the billing and coding tasks to a reliable medical billing and coding company can ensure timely claim filing and optimal reimbursement. Glaucoma is one of the leading causes of blindness for people over the age of 60. The condition can occur at any age but is more common in older adults. Reports suggest that currently, more than 3 million people in the United States have glaucoma. According to estimates from the National Eye Institute, this number is expected to reach 4.2 million by the end of 2030- reporting a 58 percent increase. As mentioned above, glaucoma in most cases is associated with higher-than-normal pressure inside the eye – a condition called ocular hypertension. But it can also occur when intraocular pressure(IOP) is normal. Risk factors associated with the condition include – eye injuries or conditions, eye surgery, having corneas that are thin in the center, having high internal eye pressure, old age, myopia (nearsightedness), consuming corticosteroids (especially eye drops for a long time) and other illnesses and conditions like diabetes and hypothyroidism. If untreated or uncontrolled, glaucoma first causes peripheral vision loss and eventually can lead to blindness. www.outsourcestrategies.com 918-221-7769

2. Types of Glaucoma There are different types of glaucoma and these include –  Open-angle glaucoma - This is the most common form of glaucoma. In this type, the drainage angle formed by the cornea and iris remains open, but the trabecular meshwork is partially blocked. This causes pressure in the eye to gradually increase which in turn damages the optic nerve. The condition occurs so slowly that vision loss occurs before the affected person is even aware about the same. Angle-closure glaucoma –Also called closed-angle glaucoma, this type occurs when the iris bulges forward to narrow or block the drainage angle formed by the cornea and iris. As a result, fluid cannot circulate through the eye and pressure increases. Angle-closure glaucoma may occur either suddenly or gradually. Normal-tension glaucoma– The exact reason for this type of glaucoma is unknown. In this type, the optic nerve becomes damaged even though the eye pressure is within the normal range. Pigmentary glaucoma– In this type, pigment granules from your iris build up the drainage channels, slowing or blocking the fluid exiting from your eye.    Glaucoma may also occur among children and infants. The condition may be present from birth or develop within the first few years of life. The optic nerve damage may be caused by drainage blockages or an underlying medical condition. What Are the Immediate Symptoms? Most types of glaucoma typically cause no pain and produce no symptoms until noticeable vision loss occurs. The signs and symptoms of the eye condition may depend on the type and stage of the eye condition. Common symptoms include -          Severe headache Eye pain Blurred vision Eye redness Halos around lights Nausea and vomiting Patchy blind spots in your side (peripheral) or central vision, frequently in both eyes Sudden, unexpected vision problems, especially when lighting is poor Tunnel vision in the advanced stages Diagnosing and Treating Glaucoma and Related ICD-10 Codes Glaucoma diagnosis may begin with a detailed review of the patient’s medical history and a comprehensive eye examination. Ophthalmologists may perform several tests like – tonometry (measuring intraocular pressure), visual field test (checking for areas of vision loss), pachymetry (measuring corneal thickness), gonioscopy (inspecting the drainage angle) and testing for optic nerve damage with a dilated eye examination and imaging tests. The damage caused to the optic nerve cannot be reversed, in most cases. However, correct treatment and regular eye checkups can help slow or prevent vision loss, especially if the www.outsourcestrategies.com 918-221-7769

3. disease is caused in its early stages. Initial treatment may focus on lowering the eye pressure (intraocular pressure). Depending on individual patient condition, treatment modalities may comprise prescription eye drops (Prostaglandins, beta blockers, Alpha- adrenergic agonists), oral medications, laser treatment, surgery or a combination of any of these. Surgery and other therapies may be performed to improve the drainage of fluid within the eye, thereby lowering pressure. Surgical options include – laser therapy, drainage tubes, filtering surgery and minimally invasive glaucoma surgery (MIGS). Ophthalmologists or other specialists need to report the symptoms, diagnosis, screening tests and other procedures using the correct medical codes. Ophthalmology medical billing services offered by professional billing and coding companies ensure this so that accurate claim submissions are done. ICD-10 codes for glaucoma diagnosis include – H40 – Glaucoma H40.0 Glaucoma suspect        H40.00 Preglaucoma, unspecified H40.01 Open angle with borderline findings, low risk H40.02 Open angle with borderline findings, high risk H40.03 Anatomical narrow angle H40.04 Steroid responder H40.05 Ocular hypertension H40.06 Primary angle closure without glaucoma damage H40.1 Open-angle glaucoma       H40.10 Unspecified open-angle glaucoma H40.11 Primary open-angle glaucoma H40.12 Low-tension glaucoma H40.13 Pigmentary glaucoma H40.14 Capsular glaucoma with pseudoexfoliation of lens H40.15 Residual stage of open-angle glaucoma H40.2 Primary angle-closure glaucoma      H40.20 Unspecified primary angle-closure glaucoma H40.21 Acute angle-closure glaucoma H40.22 Chronic angle-closure glaucoma H40.23 Intermittent angle-closure glaucoma H40.24 Residual stage of angle-closure glaucoma H40.3 Glaucoma secondary to eye trauma     H40.30 Glaucoma secondary to eye trauma, unspecified eye H40.31 Glaucoma secondary to eye trauma, right eye H40.32 Glaucoma secondary to eye trauma, left eye H40.33 Glaucoma secondary to eye trauma, bilateral www.outsourcestrategies.com 918-221-7769

4. H40.4 Glaucoma secondary to eye inflammation     H40.40 Glaucoma secondary to eye inflammation, unspecified eye H40.41 Glaucoma secondary to eye inflammation, right eye H40.42 Glaucoma secondary to eye inflammation, left eye H40.43 Glaucoma secondary to eye inflammation, bilateral H40.5 Glaucoma secondary to other eye disorders     H40.50 Glaucoma secondary to other eye disorders, unspecified eye H40.51 Glaucoma secondary to other eye disorders, right eye H40.52 Glaucoma secondary to other eye disorders, left eye H40.53 Glaucoma secondary to other eye disorders, bilateral H40.6 Glaucoma secondary to drugs     H40.60 Glaucoma secondary to drugs, unspecified eye H40.61 Glaucoma secondary to drugs, right eye H40.62 Glaucoma secondary to drugs, left eye H40.63 Glaucoma secondary to drugs, bilateral H40.8 Other glaucoma     H40.81 Glaucoma with increased episcleral venous pressure H40.82 Hypersecretion glaucoma H40.83 Aqueous misdirection H40.89 Other specified glaucoma H40.9 Unspecified glaucoma H42 Glaucoma in diseases classified elsewhere Patients need to follow several self-care tips to prevent vision loss or slow its progress. These tips include – undergoing regular dilated eye examinations, taking prescribed eye drops regularly and wearing adequate eye protection on a daily basis. Medical billing and coding for eye conditions can be complex, as there are different codes associated with the condition. By outsourcing these tasks to established medical coding companies that offer the services of AAPC-certified coding specialists, healthcare practices can ensure correct and timely medical billing and claims submission. Outsource Strategies International 8596 E. 101st Street, Suite H Tulsa, OK 74133 Main: (800) 670 2809 Fax: (877) 835-5442 E-mail: info@managedoutsource.com www.outsourcestrategies.com 918-221-7769