Commonly Used
ICD-9-CM Codes
• This is a partial list of ICD-10-CM codes for ophthalmology.
• This document is for illustration only; it does not substitute
for a code book/file.
• This is a selection of frequently used diagnoses.
• Each physician must determine the most appropriate ICD10-CM codes for his/her practice (thru internal audit).
ICD-10-CM STRUCTURE
1st character:
alpha (no “U”)
2nd
character:
numeric
3rd–6th characters: alphanumeric
A 0 1
Category
• The most effective tool for ICD-10-CM coding is the manual
whether printed or online.
.0
1 0
Etiology, Anatomic
Site, Severity
ICD-9 Code
ICD-10 Code
ICD-9 Description
224.6
D31.3-
Choroid
250.5
E11.3--
Diabetes with ophthalmic manifestations
250.00
E11.9
Diabetes mellitus without mention of complication
362.01
E11.31-
Background diabetic retinopathy
362.11
H35.03-
Hypertensive retinopathy
362.50
H35.30
Macular degeneration, senile, unspecified
362.51
H35.31
Nonexudative senile maular degeneration
362.56
H35.37-
Macular puckering
362.57
H35.36-
Drusen
365.00
H40.00-
Preglaucoma, unspecified
365.01
H40.01
Borderline glaucoma, open angle with borderline
findings
365.04
H40.05-
Borderline glaucoma, ocular hypertension
366.04
H26.03-
Infantile, juvenile, and presenile cataract, nuclear cataract
Age limit
366.14
H25.04-
Posterior subcapsular polar senile cataract
Age limit
366.15
H25.01-
Cortical senile cataract
Age limit
366.16
H25.1-
Senile cataract, nuclear sclerosis
Age limit
Apex EDI | 476 North 1500 West | Orem, Utah 84057 | Toll Free: (800) 840-9152
Additional
characters
A
Added code
for extension
(7th character)
for obstetrics,
injuries and
external causes
of injury
Limitations
Age limit
1
Commonly Used ICD-9-CM Codes
ICD-9 Code
ICD-10 Code
ICD-9 Description
Limitations
366.19
H25.81-
Senile cataract, nuclear sclerosis
Age limit
366.19
H25.89
Other and combined forms of senile cataract
Age limit
366.19
H25.9
Other and combined forms of senile cataract
Age lmit
366.53
H26.49-
After-cataract obscuring vision
Incomplete crosswalk
367.0
H52.0-
Hypermetropia
367.1
H52.1
Myopia
367.20
H52.20
Astigmatism, unspecified
367.21
H52.22-
Regular Astigmatism
367.4
H52.4
Presbyopia
368.03
H53.02-
Refractive amblyopia
368.8
H53.8
Other specified visual disturbances
370.20
H16.10-
Superficial keratitis, unspecified
370.21
H16.14-
Punctate keratitis, without conjuncitivitis
370.33
H16.22
Keratoconjunctivitis sicca, not specified as Sjogren's
372.00
H10.2--
Accute conjunctivitis, unspecified
372.00
H10.3-
Accute conjunctivitis, unspecified
372.14
H10.45
Other Chronic allergic conjuncitvitis
372.51
H11.15-
Pinguecula
372.72
H11.3-
Conjunctival hemorrage
373.00
H01.0--
Blepharitis, unspecified
373.12
H00.02-
Hordeolum internum
374.87
H02.83-
Dermatochalasis
375.15
H04.12-
Tear film insufficiency, unspecified, Dry eye syndrome
378.83
H51.11
Convergence insufficiency or palsy
379.21
H43.81-
Vitreous degeneration
379.24
H43.39-
Other vitreous opacities
379.91
H57.1-
Pain in or around eye
2
Apex EDI | 476 North 1500 West | Orem, Utah 84057 | Toll Free: (800) 840-9152
Commonly Used ICD-9-CM Codes
ICD-9 Code
ICD-10 Code
ICD-9 Description
Limitations
401.9
I10
Essential Hypertension, unspecified
ICD 9 code does not exclude
hypertension of eye vessels, ICD 10 does exclude
the hypertension of the eye
vessels, refer to H35.--- codes
for eye specific hypertension
784.0
G44.---
Headache
784.0
R51
Headache
918.1
S05.0-X
Superficial injury of yey and adnexa, Cornea
V43.1
Z96.1
Organ or tissue replaced by other means, Lens
Can't be a principle
diagnosis code
V58.69
Z79.---
Long-term (current) use of other medications
Can't be a principle
diagnosis code
v72.0
Z01.0-
Examination of eyes and vision
Can't be a principle
diagnosis code
Please note this tool is not designed to provide perfect matches between the two coding systems. In fact, except for a minority of
cases, perfect matches between the ICD-9-CM and ICD-10-CM coding systems do not exist. Given the significant increase in detail
and specificity in the ICD-10-CM coding system, in most cases there is no direct match between ICD-9 and ICD-10 codes. A clinical
analysis is required to determine which code or codes should be used. It is important to remember that even when there is only
one ICD-10 code, it is not necessarily completely equivalent to the source ICD-9 code. This tool is not designed to replace proper
training and documentation.
Proper coding begins with the doctor and documentation. While Medicare Part B is not going to deny claims based solely on the
specificity of the ICD-10 diagnosis code as long as the codes are from the right family, they may pay less than what they have paid
in the past based on the specificity of the diagnosis code. These tools are meant to shorten the amount of time spent looking up
codes for best specificity. Most of the conversions identify the family where the appropriate crosswalk can be found. In the rare
occasions where there is a direct crosswalk a clinical analysis is still required to determine if the crosswalk is appropriate for the
billing situation.
Apex EDI | 476 North 1500 West | Orem, Utah 84057 | Toll Free: (800) 840-9152
3