The need for outsourced medical billing and coding increases as scientific discoveries add new dimensions to existing health conditions, making coding tricky. Dry eye pain could be one such condition. It is estimated that 5% to 30% of older Americans have dry eye, which makes proper dry eye documentation and billing crucial to the financial health of your practice.
ICD-10 Coding for Dry Eye
Even as things stand, ICD-10 medical coding is something that takes time to master. The ICD-10-CM diagnosis code for dry eye syndrome affecting a lacrimal gland is H04.12 – this is a non-billable code because there are 4 other codes below this that are more specific such as:
H04.121 – Dry eye syndrome of right lacrimal gland
H04.122 – Dry eye syndrome of left lacrimal gland
H04.123 – Dry eye syndrome of bilateral lacrimal glands
H04.129 – Dry eye syndrome of unspecified lacrimal gland
The above 4 specific codes can be reported on medical claims and are billable. Though CMS is a bit lenient at present, from October 1, 2016 Medicare will start denying claims on the basis of the specificity of the ICD-10 diagnosis codes.
Moving on to latest developments in eye care, here is some interesting information on dry eye pain recently highlighted by researchers.
More than Just an Eye Issue
Dry eye pain could be the cause of more than just pain in the eye, if physician-researchers of UHealth’s Bascom Palmer Eye Institute are to be believed. They note that various chronic pain syndromes can be linked to dry eye. The study by researchers revealed that some of their patients suffering from dry eye experience corneal somatosensory pathway dysfunction and can therefore be considered as suffering from neuropathic ocular pain. The research was published in a recent issue of the “Journal of Pain” of the American Pain Society.
Dry eye, on the surface, appears to be a simple matter – the result of the eyes not producing the required supply of tears or the result of tears evaporating too soon from cornea surface. But, as you know, it causes pain and itchiness, and could result in inflammation, scars or ulcers on the cornea.
Dry Eye and Chronic Pain
Dry eye is already a public health issue. Apart from the classic symptoms of ocular pain, irritation and blurred vision, transient pain is reported by some patients while others do experience chronic pain. Chronic pain has been identified to be more likely in patients having ocular sensory apparatus dysfunction or neuropathic ocular pain. Dysfunction reveals itself through allodynia, spontaneous dysesthesias, hyperalgesia as well as functional and morphologic abnormalities of the corneal nerve.
The American Eye Institute reveals that around 3 million Americans are affected by this condition each year, which means the chronic pain conditions could be quite prevalent as well.
The research team from the Bascom Palmer Eye Institute carried out an evaluation of 154 patients with dry eye. The patients reported:
- Greater levels of ocular as well as non-ocular pain normally associated with various chronic pain conditions, and
- Lower quality of life indices and depression scores indicating some central sensitivity disorder
The researchers also believe that neuropathic ocular pain could have casual genetic factors similar to those of other chronic pain conditions that could be overlapping in the patients.
The discovery of such a connection between dry eye pain and other chronic pain conditions could give rise to the need for a fresh paradigm for treatment and diagnosis, if patient outcomes are to be improved as per the results of the study.