Low vision refers to chronic visual impairments that cannot be corrected with glasses, contact lenses, or medical or surgical treatment. Low vision includes different degrees of sight loss, from blind spots, poor night vision and problems with glare to an almost complete loss of sight. Blindness and low vision are not the same, as limited sight remains in the latter condition. Ophthalmologists and optometrists treating this eye condition can take the help of professional medical billing services for accurate claim submission.
As you know, February is low vision awareness month and it is also national age-related macular degeneration (AMD) month. AMD is the leading cause of low vision and blindness. Other causes include glaucoma, cataract or diabetes. This month is meant to spread awareness about vision rehabilitation that can help people with low vision learn how to stay independent and make the most of their sight.
Getting a yearly exam increases the chances of early detection and diagnosis of conditions that may lead to vision loss. Low vision can make it harder to do things like reading, shopping, or cooking. Ophthalmologists and optometrists concerned with the eye and vision, measure visual impairments by making patients read letters on a vision chart, which is called as visual acuity. Two categories of low vision are – Partially sighted and Legally blind. Partially sighted refers to visual acuity between 20/70 and 20/200 with conventional prescription lenses and Legally blind refers to visual acuity no better than 20/200 with conventional correction and/or a restricted field of vision less than 20 degrees wide. Visual aids are helpful for people with low vision. Popular low vision aids include telescopic glasses, lenses that filter light, magnifying glasses, hand magnifiers, closed-circuit television and reading prisms.
Categories to Report Low Vision and Blindness
To document low vision and blindness in medical claims, the categories are – mild or no visual impairment, moderate, severe, and blindness. ICD 10 Monitor provides a clear idea of those categories. Check out the image below –
H54 ICD-10 Codes to Report Blindness and Low Vision
H54 Blindness and low vision
- H54.0 Blindness, both eyes
- H54.0X Blindness, both eyes, different category levels
- H54.0X3 Blindness right eye, category 3
- H54.0X33 Blindness right eye category 3, blindness left eye category 3
- H54.0X34 Blindness right eye category 3, blindness left eye category 4
- H54.0X35 Blindness right eye category 3, blindness left eye category 5
- H54.0X4 Blindness right eye, category 4
- H54.0X43 Blindness right eye category 4, blindness left eye category 3
- H54.0X44 Blindness right eye category 4, blindness left eye category 4
- H54.0X45 Blindness right eye category 4, blindness left eye category 5
- H54.0X5 Blindness right eye, category 5
- H54.0X53 Blindness right eye category 5, blindness left eye category 3
- H54.0X54 Blindness right eye category 5, blindness left eye category 4
- H54.0X55 Blindness right eye category 5, blindness left eye category 5
- H54.0X3 Blindness right eye, category 3
- H54.0X Blindness, both eyes, different category levels
- H54.1 Blindness, one eye, low vision other eye
- H54.10 …… unspecified eyes
- H54.11 Blindness, right eye, low vision left eye
- H54.113 Blindness right eye category 3, low vision left eye
- H54.1131 …… category 1
- H54.1132 …… category 2
- H54.114 Blindness right eye category 4, low vision left eye
- H54.1141 …… category 1
- H54.1142 …… category 2
- H54.115 Blindness right eye category 5, low vision left eye
- H54.1151 …… category 1
- H54.1152 …… category 2
- H54.12 Blindness, left eye, low vision right eye
- H54.121 Low vision right eye category 1, blindness left eye
- H54.1213 …… category 3
- H54.1214 …… category 4
- H54.1215 …… category 5
- H54.122 Low vision right eye category 2, blindness left eye
- H54.1223 …… category 3
- H54.1224 …… category 4
- H54.1225 …… category 5
- H54.11 Blindness, right eye, low vision left eye
- H54.10 …… unspecified eyes
- H54.2 Low vision, both eyes
- H54.2X Low vision, both eyes, different category levels
- H54.2X1 Low vision, right eye, category 1
- H54.2X11 Low vision right eye category 1, low vision left eye category 1
- H54.2X12 Low vision right eye category 1, low vision left eye category 2
- H54.2X2 Low vision, right eye, category 2
- H54.2X21 Low vision right eye category 2, low vision left eye category 1
- H54.2X22 Low vision right eye category 2, low vision left eye category 2
- H54.2X1 Low vision, right eye, category 1
- H54.2X Low vision, both eyes, different category levels
- H54.3 Unqualified visual loss, both eyes
- H54.4 Blindness, one eye
- H54.40 …… unspecified eye
- H54.41 Blindness, right eye, normal vision left eye
- H54.413 Blindness, right eye, category 3
- H54.413A Blindness right eye category 3, normal vision left eye
- H54.414 Blindness, right eye, category 4
- H54.414A Blindness right eye category 4, normal vision left eye
- H54.415 Blindness, right eye, category 5
- H54.415A Blindness right eye category 5, normal vision left eye
- H54.413 Blindness, right eye, category 3
- H54.42 Blindness, left eye, normal vision right eye
- H54.42A Blindness, left eye, category 3-5
- H54.42A3 Blindness left eye category 3, normal vision right eye
- H54.42A4 Blindness left eye category 4, normal vision right eye
- H54.42A5 Blindness left eye category 5, normal vision right eye
- H54.42A Blindness, left eye, category 3-5
- H54.5 Low vision, one eye
- H54.50 …… unspecified eye
- H54.51 Low vision, right eye, normal vision left eye
- H54.511 Low vision, right eye, category 1-2
- H54.511A Low vision right eye category 1, normal vision left eye
- H54.512A Low vision right eye category 2, normal vision left eye
- H54.511 Low vision, right eye, category 1-2
- H54.52 Low vision, left eye, normal vision right eye
- H54.52A Low vision, left eye, category 1-2
- H54.52A1 Low vision left eye category 1, normal vision right eye
- H54.52A2 Low vision left eye category 2, normal vision right eye
- H54.52A Low vision, left eye, category 1-2
- H54.6 Unqualified visual loss, one eye
- H54.60 …… unspecified
- H54.61 Unqualified visual loss, right eye, normal vision left eye
- H54.62 Unqualified visual loss, left eye, normal vision right eye
- H54.7 Unspecified visual loss
- H54.8 Legal blindness, as defined in USA
It is important for the coding and billing staff to be very cautious in choosing specific codes, and they must be up to date with the payer policies to avoid claim rejections. Reliable ophthalmology medical coding services help practices to submit accurate medical claims, and thus receive reimbursement on time.
Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.