- Many result from diseases such as: - - diabetes -- sickle cell anemia -- birth prematurity -- arteriosclerosis - - - use dagger/asterisk when these are the cause of retinal disorder - Flourescein angiography - - dx procedure to assess extent of disease

Eye & Adnexa Flashcards by R Hernandez

Intraocular pressure measurement in ambulatory care

2.CZ.28.^^

Mandatory to code in ambulatory care
Search Lead term:
- Measurement
Search Secondary:
- Intraocular

Footnote
Think about what is being measured, it’s why you measure the intraocular

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Intraocular pressure measurement inpatient settings

2.CZ.28.^^

“Optional to code for inpatient data

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Age related cataracts

H25.1

Means senile cataracts or nuclear sclerosis cataracts
- do not make assumptions based on PT age
- primarily affects nucleus
- - do not assume nucleus if not stated where affected
- occur more frequenty in type 2 diabetics
- - make sure to assign E11.38 ~ type 2 diabetes mellitus with other specified ophthalmic complications

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Traumatic Cataract

H26.1 ~ Traumatic Cataract
Use external codes - figure out how many

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Drug related cataract

H26.3 ~ Drug-induced Cataract
- + additional external cause code to identify the cause or drug

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Diabetic Cataract

H28.0* ~ Diabetic Cataract

True diabetic cataract is rare
- Must be clearly stated as such
- Occur in Type 1 diabetics
- - is this only in type 1 diabetics or primarily?
- Has rapid onset

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Excision, total, lens

1.CL.89.^^

Qualifiers identify extraction technique and type of prosthetic lens used

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Intracapsular Extraction

Removal of lens with capsule
- relatively rare nowadays

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Extracapsular extraction

Incision into anterior capsule
- removing lens while leaving lens capsule (capsular bag) in posterior chamber to hold new lens

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Phacoemulsification

1.CL.89.VR.^^

Type of extracapsular extraction
- Ultrasonic probe breaks up lens
- Pieces removed with an aspirator
- Most common method used today
NOTE THE R IMPLIES REMOVAL OF LENS W/O REPLACEMENT

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Phacoemulsification using Femtosecond Laser

1.CL.89.VO
- + will likely have to code additional intervention
- - 3.CZ.94.ZF ~ Imaging intervention NEC, eye NEC

Also known as bladeless phacoemulsification
type of extracapsular extraction
- Uses laser and imaging OCT (optical coherence tomography) for greater precision

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Pt has subsequent lens insertion in different episode of care than phacoemulsification

1.CL.53.^^ ~ Implantation of internal device, lens

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Artificial lens removed without replacement or replacement with a different type of lens then the removal

1.CL.55.^^ ~ Removal of device, lens

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After-Cataract - same as secondary cataract
Treated with YAG laser Capsulotomy

H26.4
Treated with YAG laser Capsulotomy
- 1.CL.59.LA-AG - destruction lens using open approach and laser

Lead: after-cataract
Opacification of posterior capsule
- due to partialy absorbed
- OR
- Following cataract extraction

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Retinal Disorders

Many result from diseases such as:
- diabetes
  – sickle cell anemia
  – birth prematurity
  – arteriosclerosis
- - use dagger/asterisk when these are the cause of retinal disorder
Flourescein angiography
- dx procedure to assess extent of disease

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Nonproliferative retinopathy

E1^.30 ~ DM with moderate nonproliferative retinopathy
H36.0* ~ diabetic retinopathy (Dx type 3 or 6)

May be further described as:
- mild
-moderate
- severe
- - based on presenting signs

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Preproliferative retinopathy

E1^.31 ~ DM with preproliferative retinopathy
H36.0* ~ diabetic retinopathy (Dx type 3 or 6)

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Macular pathology present

E1^.33 ~ DM with other retinopathy
H36.0* ~ diabetic retinopathy

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Treatment w/ anti-VEGF or focal laser treatment (grid photocoagulation)

1.CN.59.LA-AG ~ destruction retina, using laser
1.CM.35.HA-CC ~ pharmacotherapy vitreous

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Proliferative Retinopathy, w/o mention of retinal detachment or vitreous hemorrhage

E1^.32 ~ DM with proliferative retinopathy
H36.0* ~ diabetic retinopathy

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Proliferative Retinopathy WITH retinal detachment or vitreous hemorrhage present

Study These Flashcards

E1^.33 ~ DM with other retinopathy
H36.0* ~ diabetic retinopathy
- + code seperately instructions for
- -Retinal detachment – H33.4
- - Vitreous hemorrhage – H43.1

Arteriosclerotic Retinopathy

Study These Flashcards

I70.8 ~ atherosclerosis other arteries
H36.8* ~ other retinal disorders in disease classified elsewhere

Hypertensive retinopathy

Study These Flashcards

H35.0 ~ background retinopathy and retinal vascular changes
Assign additional code for hypertension, mandatory 3/OP

Retinal Detachment

Study These Flashcards

H33.^ ~ retinal detachment and breaks

Complete or partial separation of inner layer of retina from the retinal pigment epithelium
Three types:
- Rhegmatogenous
- - Most common
- - Tear or break in retina permitting fluid to seep between the layers

Tractional
- Scar tissue that forms inside the vitreous and on the retina’s surface contracts and causes detachment.
exudative serous
- Detachment occurs when another condition, such as an inflammation causes fluid from the vessels behind the retina to leak between the retinal layers.

Treatment for retinal detachement

Treatment – 1.CN.59.^^ ~ destruction retina - can be one of these (scar created): - - Cryosurgery – 1.CN.59.LA-AD - - Photocoagulation – 1.CN.59.LA-AG - - Electrodiathermy - 1.CN.59.LA-GX - - Multiple devices – 1.CN.59.LA-GY

Pneumatic Retinopexy

1.CM.35.HA-V0 ~ Pharmacotherapy (local), vitreous, of air or gas using needle injection performed for small uncomplicated detachment

Scleral Buckling

1.CD.53.LA-KT ~ Implantation of internal device, sclera, of scleral buckle [explant] - Look up scleral buckling applies pressure to keep seal from becoming detached

Posterior Vitrectomy (Pars Plana vitrectomy)

1.CM.89.^^

Removal of silicone post posterior vitrectomy - ICD

Z48.8 ~ other specified surgical follow up care Look up lead and secondary terms

Anterior Vitrectomy

1.CJ.52.LL

Membrane peeling

1.CN.72.LA ~ release retina reattachment may not be possible Release, retina search terms

ARMD, AMD, Macular Degeneration

H35.3 ~ degeneration macula Major cause of visual impairment (loss of central vision) - Deterioration of cells of macula - - Age related macular degeneration – AMD

IMT (Implantable Miniature Telescope)

one of the following: - 1.CL.89.NP-LO - 1.CL.89.VR-LO - 1.CL.89.VO-LO Removal of lens and replace with IMT

Primary - open angle/ angle closure

H40.^

Secondary glaucoma

H40.^ + additional code for underlying cause

Congenital glaucoma

Q15.0

Treatment glaucoma

Surgically treated – day surgery/local anesthesia Either increase drainage or decrease production of aqueous humour

iridotomy/Partial Iridectomy

1.CH.87.LA-AG ~ excision partial iris, using laser

Drainage anterior chamber

1.CJ.52.^^ ~drainage anterior chamber Also called: trabeculoplasty (Argon laser)

Scleral Drainage

1.CD.52.^^ ~ drainage sclera Also called scleral fistulization or trabeculostomy Commonly performed via laser

Destruction ciliary body

1.CG.59.^^ ~ destruction ciliary body (qualifier 2 identifies type of device used – laser or cryotherapy) Decreases production of aqueous humour

Corneal Dystrophies

H18.5 ~ Hereditary corneal dystrophies Foreign material accumulates in one or more layers of cornea - find search terms

Keratoconus

H18.6 ~ Keratoconus Progressive thinning of the cornea which leads to bulging and a cone-like shape of cornea

Corneal Collagen Cross-linking

Epithelium – on 1.CC.12.JA-DQ Epithelium – off 1.CC.87.LA-DQ - CCI code depends on whether performed as “epithelium – on” or “epithelium – off” - Halts or slows degeneration of vision

Corneal Transplantation

1.CC.85.^^ Replacement of cornea

Glaucoma

(H40.^) - Disturbance of structural or functional integrity of optic nerve causing atrophic changes to optic nerve - Lowering intraocular pressure (IOP) can arrest or diminish condition - - SEE TABLE 16.1 page 16.7 Primer

AMD

Age related macular degeneration

IMT

Implantable Miniature Telescope

IOL

Intraocular Lens

Ocular dexter (right eye)

Ocular sinister (left eye)

Eye & Adnexa Flashcards

(51 cards)