Cracking the Code
Coding Glaucoma
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What is glaucoma? According to the American Academy of Ophthalmology, glaucoma is a disease that damages your eye’s optic nerve. It usually happens when fluid builds up in the front part of your eye. The extra fluid increases the pressure in your eye which damages the optic nerve. There are causes and risk factors for glaucoma. It mainly affects adults over 40, but young adults, children, and infants can be diagnosed with glaucoma. Other risk factors include (but are not limited to) diabetes, high blood pressure, heart disease, sickle cell disease, or corneas that are thinner than usual. Patients that take certain medications for bladder control or seizures could also be at risk for glaucoma.
Symptoms of glaucoma include seeing halos around lights, vision loss, an eye that looks hazy, and eye pain to name a few. Different treatments for glaucoma can be eye drops, oral medication, or laser surgery. Other procedures such as trabeculoplasty, iridotomy, and cyclophotocoagulation can also be used to treat glaucoma patients.
Glaucoma codes are in category H40 in the ICD-10-CM codebook. Congenital glaucoma can be found in category Q15. Coding for glaucoma also includes the type and stage. In addition, laterality is also included in the choice of codes. ICD-10-CM guidelines 1.C.7.a 2 and 1.C.7.a.3 have specific rules for coding bilateral glaucoma with the same or different types and stages.
When a patient has bilateral glaucoma and both eyes are documented as the same type and stage, and there is a code for bilateral glaucoma, a code is assigned for bilateral glaucoma with the appropriate 7th character for the stage.
When a patient has bilateral glaucoma and both eyes are the same type and stage, and the classification does not provide a code for bilateral glaucoma (H40.10, H40.20), report only one code for the type of glaucoma with a 7th character for the stage.
When the patient has bilateral glaucoma and each eye is a different type, and the classification does not distinguish laterality (H40.10, H40.20), assign a code for each type of glaucoma with the appropriate 7th character for the stage.
When a patient has bilateral glaucoma and each eye is the same type, but at a different stage and the classification doesn’t distinguish laterality (H40.10, H40.20), assign a code for the type of glaucoma for each eye with the 7th character for the glaucoma stage for each eye.