What Do BTS, Parkways and ICD-10 Have in Common?

Brett Paepke, OD, RevolutionEHR Director of ECP Services

­If you’re anything like me, you’re wondering three things right now:

1. Who is BTS and why are they so popular?
2. Why do we park on a driveway and drive on a parkway?
3. What are this year’s ICD-10 changes?

Wait…you’re not wondering any of those things? Congratulations! I’d worry about you if you were. But at the risk of ignoring Nos. 1 and 2, let’s talk a bit about the ICD-10 changes that went into effect October 1.

First, a bit of background to set the stage. Remember that ICD-10 offers us greater specificity than ICD-9 did and, in turn, allows health care systems to better track what conditions they’re managing, how diseases interrelate, etc. With that specificity comes many more available codes. There were around 13,000 ICD-9 codes in 2015 and, at the time of implementation, there were around 68,000 ICD-10 codes.  That number has since grown to slightly over 72,000.

Each year a review panel meets multiple times to review stakeholder feedback about codes that should be added, removed, or edited and ultimately decides on the changes to be implemented on October 1 of that year. You’ll remember in 2016 we saw a high number of additions including new codes for glaucoma, macular degeneration and diabetic retinopathy. 2017 brought us fewer changes but involved adding new codes for degenerative myopia and low vision. 2018 added a number of eyelid-related codes, including the long-awaited ability to represent meibomian gland dysfunction.

The changes offer a bit of relief to eye care. Specifically, just 68 new eye-related codes will go into effect this fall but they involve only four main areas:

• Orbital fractures. Previously, ICD-10 accounts for only fractures of the orbital floor. Since October 1, fractures of the roof, medial wall, and lateral wall will all be represented with codes.
• Ehlers-Danlos syndrome. The nondescript Q79.6 will be replaced by five new codes designed to provide more detail.
• Vertigo. In a bit of a departure from the norm of adding specificity, ICD-10 will delete four descriptive codes for vertigo in favor of a new less descriptive one.
• Two new codes to account for exams performed on the basis of a failed vision screening.

As we’ve done since the very first of these annual updates, we’ve prepared a guide of the eye-specific changes to give you a quick resource to reference. Note that the document contains three columns: Action, Code and Description. The “Action” column describes what is happening to the code to the right of it and will contain “Delete” or “Add." Each area of change is also grouped together to allow easier visualization. We hope you find this guide helpful.