Implementing New & Revised ICD-10 Codes John A. McGreal Jr., O.D. McGreal Educational Institute Excellence in Optometric Education John A. McGreal Jr., O.D. McGreal Educational Institute 11710 Old Ballas Rd. St. Louis, MO. 63141 314.569.2020 314.569.1596 FAX mcgrealjohn@gmail.com 2018 Government Changes Medicare Legislative & Payment Model Changes Medicare Updates for 2018 Quality Program Changes Value Based Payment Modifier Electronic Health Record MU Program Changes Merit Based Incentive Program Changes OIG Updates RAC Updates ICD-10 Updates for 2018 2018 Government Changes to Fees Medicare Deductible part B is $183 for 2018 Same as 2017 Medicare Part B standard monthly premium is $134 Filers with <$85,000/individual, $170,000/joint income Medicare Part B monthly premium is $187.50 Filers with $85,000-107,000/indiv, $170-214,000/joint Medicare Part B monthly premium is $267.90 Filers with $107-133,500/indiv, $214-267,000/joint Social Security Administration announced a COLA of 2 % for 2018 New ICD-10 Codes for 2018 360 new codes, 226 code description revisions 34 codes changed from valid to invalid, 122 codes deleted Validity changes new codes added, changing previously valid to invalid codes, creating a new subcategory eyes H54.11 Blindness right, low vision left H54.12 Blindness left, low vision right H54.51 Low vision right, normal left H54.52 Low vision left, normal right Revised Title H02.05 Trichiasis w/o entropion H02.051 Trichiasis w/o entropion, right upper lid H02.052 Trichiasis w/o entropion, right lower lid H02.053 Trichiasis w/o entropion, right, unspecified H02.054 Trichiasis w/o entropion, left upper lid H02.055 Trichiasis w/o entropion, left, lower lid H02.056 Trichiasis w/o entropion, left, unspecified H02.059 Trichiasis w/o entropion, unspec eye, unspec lid
H44.2A Degenerative myopia (w choroidal neov) H44.2A1 Degenerative myopia (w choroidal neov) right H44.2A2 Degenerative myopia (w choroidal neov) left H44.2A3 Degenerative myopia (w choroidal neov) both H44.2A9 Degenerative myopia (w choroidal neov) unspec H44.2B Degenerative myopia (w macular hole) H44.2B1 Degenerative myopia (w macular hole) right H44.2B2 Degenerative myopia (w macular hole) left H44.2B3 Degenerative myopia (w macular hole) both H44.2B9 Degenerative myopia (w macular hole) unspec H44.2C Degenerative myopia (w RD) H44.2C1 Degenerative myopia (w RD) right H44.2C2 Degenerative myopia (w RD) left H44.2C3 Degenerative myopia (w RD) both H44.2C9 Degenerative myopia (w RD) unspec H44.2D Degenerative myopia (w foveal schisis) H44.2D1 Degenerative myopia (w foveal schisis) right H44.2D2 Degenerative myopia (w foveal schisis) left H44.2D3 Degenerative myopia (w foveal schisis) both H44.2D9 Degenerative myopia (w foveal schisis) unspec H44.2E Degenerative myopia (w other maculopathy) H44.2E1 Degenerative myopia (w other maculop) right H44.2E2 Degenerative myopia (w other maculop) left H44.2E3 Degenerative myopia (w other maculop) both H44.2E9 Degenerative myopia (w other maculop) unspec Blindness & Low Vision Codes 2018 CMS added over 50 blindness and low vision codes Allows coding of right and left eyes when different categories of disease exists or Low vision in one eye and blindness in the other, along with creating new subcategories of each
H54.0X3 Blindness, right, category 3 H54.0X33 Blindness, right, left category 3 H54.0X34 Blindness, right, category 3, left category 4 H54.0X35 Blindness, right, category 3, left category 5 H54.0X4 Blindness, right, category 4 H54.0X43 Blindness, right category 4, left category 3 H54.0X44 Blindness, right category 4, left category 4 H54.0X45 Blindness, right, category 4, left category 5 H54.0X5 Blindness, right, category 5 H54.0X53 Blindness, right category 5, left category 3 H54.0X54 Blindness, right category 5, left category 4 H54.0X55 Blindness, right, category 5, left category 5 H54.0X5 Blindness, right, category 5 H54.0X53 Blindness, right category 5, left category 3 H54.0X54 Blindness, right category 5, left category 4 H54.0X55 Blindness, right, category 5, left category 5 H54.11 Blindness, right, low vision left H54.113 Blindness, right category 3, low vision left H54.1131 Blindness, right category 3, low vis left cat 1 H54.1132 Blindness, right category 3, low vis left cat 2 H54.11 Blindness, right, low vision left H54.114 Blindness, right category 4, low vision left H54.1141 Blindness, right category 4, low vis left cat 1 H54.115 Blindness, right category 5, low vis left H54.1151 Blindness, right category 5, low vis left cat 1 H54.1152 Blindness, right category 5, low vis left cat 2
H54.12 Blindness, left, low vision right H54.121 Low vision, right, cat 1, blindness left H54.1213 Low vision, right, cat 1, blindness left, cat 3 H54.1214 Low vision, right, cat 1, blindness left, cat 4 H54.1215 Low vision, right, cat 1, blindness left, cat 5 H54.12 Blindness, left, low vision right H54.122 Low vision, right, cat 2, blindness left H54.1223 Low vision, right, cat 2, blindness left, cat 3 H54.1224 Low vision, right, cat 2, blindness left, cat 4 H54.1225 Low vision, right, cat 2, blindness left, cat 5 H54.2 Low vision, both H54.2X1 Low vision, right, cat 1 H54.2X11 Low vision, right, cat 1, low vision, left, cat 1 H54.2X12 Low vision, right, cat 1, low vision, left, cat 2 H54.2X2 Low vision, right, cat 2 H54.2X21 Low vision, right, cat 2, low vision, left, cat 1 H54.2X22 Low vision, right, cat 2, low vision, left, cat 2 H54.4 Blindness, one eye H54.40 Blindness, unspec H54.41 Blindness, right, normal left H54.413 Blindness, right, cat 3 H54.413A Blindness, right, cat 3, normal left H54.414 Blindness right, cat 4 H54.414A Blindness, right, cat 4, normal left H54.415 Blindness, right, cat 5 H54.415A Blindness, right, cat 5, normal left H54.42 Blindness, left, normal right H54.42A Blindness, left, cat 3-5 H54.42A3 Blindness, left, cat 3, normal right H54.42A4 Blindness, left, cat 4, normal right H54.42A5 Blindness, left, cat 5, normal right H54.5 Low vision, one eye H54.50 Low vision, unspec H54.51 Low vision, right, normal left H54.511 Low vision, right, cat 1-2 H54.511A Low vision, right, cat 1, normal left H54.512A Low vision, right, cat 2, normal left H54.52 Low vision, left, normal right H54.52A Low vision, left, cat 1-2 H54.52A1 Low vision, left, cat 1, normal right H54.52A2 Low vision, left, cat 2, normal left
Monitor Compliance with Audits Develop a Documentation team Monthly Assessment 10 charts/provider minimum OIG Compliance Report your Results All staff, residents, students Acknowledge positive & negative variances RETRAIN, RETRAIN.. THANK YOU! Primary Eyecare Network 1.800.444.9230 www.primaryeye.net Medicare Compliance Kit Health History Questionnaire Examination Forms E/M Worksheets ICD-10 Codes Interpretation/Report form Medicare A-Z Manual CSI s HIPAA Compliance Manual PQRS Card ICD-10 Common Diagnosis Card Thank you McGreal Educational Institute Excellence in Optometric Education