Ophthalmology and Optometry Coding Alert

Question: I’m new to optometry/ophthalmology coding and I’m having trouble determining the differences between the myopic degeneration codes.

Could you please explain how to select the correct code?

Nebraska Subscriber

Answer: The myopic degeneration codes are listed under the H44.2- (Degenerative myopia) subcategory in the ICD-10-CM code book. When the provider documents a diagnosis of degenerative myopia, you’ll assign any of the following codes, depending on the documentation:

• H44.20 (Degenerative myopia, unspecified eye)
• H44.21 (Degenerative myopia, right eye)
• H44.22 (Degenerative myopia, left eye)
• H44.23 (Degenerative myopia, bilateral)

Further into the H44.2- subcategory, you’ll append 5^th characters when myopic degeneration is present with another condition. These additional subcategories include:

• H44.2A- (Degenerative myopia with choroidal neovascularization)
• H44.2B- (Degenerative myopia with macular hole)
• H44.2C- (Degenerative myopia with retinal detachment)
• H44.2D- (Degenerative myopia with foveoschisis)
• H44.2E- (Degenerative myopia with other maculopathy)

You’ll need a 6^th character to complete the codes for each of the subcategories listed above. Use 6^th characters 1, 2, and 3 to report the condition affecting the right, left, and both eyes, respectively. If the provider does not specify laterality, then you’ll use 6^th character 9.

Tip: Use H44.2A- through H44.2E- when the optometrist or ophthalmologist diagnoses the patient with myopic degeneration with another condition. You may also need another code to specify the associated condition — review code notes in the ICD-10-CM code book for further information.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC