Notification



Notification Issue Date:



Policy Attachment


Attachment to Policy # 07.13.07j


Attachment:A

Policy #:07.13.07j

Description:ICD-10-CM codes

Title:Corneal Pachymetry Using Ultrasound


Inclusion of a code in this table does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

The codes listed below are updated on a regular basis, in accordance with nationally accepted coding guidelines. Therefore, this policy applies to any and all future applicable coding changes, revisions, or updates.

In order to ensure optimal reimbursement, all health care services, devices, and pharmaceuticals should be reported using the billing codes and modifiers that most accurately represent the services rendered, unless otherwise directed by the Company.



H18.10 Bullous keratopathy, unspecified eye

H18.11 Bullous keratopathy, right eye

H18.12 Bullous keratopathy, left eye

H18.13 Bullous keratopathy, bilateral

H18.20 Unspecified corneal edema

H18.211 Corneal edema secondary to contact lens, right eye

H18.212 Corneal edema secondary to contact lens, left eye

H18.213 Corneal edema secondary to contact lens, bilateral

H18.219 Corneal edema secondary to contact lens, unspecified eye

H18.221 Idiopathic corneal edema, right eye

H18.222 Idiopathic corneal edema, left eye

H18.223 Idiopathic corneal edema, bilateral

H18.229 Idiopathic corneal edema, unspecified eye

H18.231 Secondary corneal edema, right eye

H18.232 Secondary corneal edema, left eye

H18.233 Secondary corneal edema, bilateral

H18.239 Secondary corneal edema, unspecified eye

H18.50 Unspecified hereditary corneal dystrophies

H18.51 Endothelial corneal dystrophy

H18.52 Epithelial (juvenile) corneal dystrophy

H18.53 Granular corneal dystrophy

H18.54 Lattice corneal dystrophy

H18.55 Macular corneal dystrophy

H18.59 Other hereditary corneal dystrophies

H18.601 Keratoconus, unspecified, right eye

H18.602 Keratoconus, unspecified, left eye

H18.603 Keratoconus, unspecified, bilateral

H18.609 Keratoconus, unspecified, unspecified eye

H18.611 Keratoconus, stable, right eye

H18.612 Keratoconus, stable, left eye

H18.613 Keratoconus, stable, bilateral

H18.619 Keratoconus, stable, unspecified eye

H18.621 Keratoconus, unstable, right eye

H18.622 Keratoconus, unstable, left eye

H18.623 Keratoconus, unstable, bilateral

H18.629 Keratoconus, unstable, unspecified eye

H18.70 Unspecified corneal deformity

H18.711 Corneal ectasia, right eye

H18.712 Corneal ectasia, left eye

H18.713 Corneal ectasia, bilateral

H18.719 Corneal ectasia, unspecified eye

H18.791 Other corneal deformities, right eye

H18.792 Other corneal deformities, left eye

H18.793 Other corneal deformities, bilateral

H18.799 Other corneal deformities, unspecified eye

H21.551 Recession of chamber angle, right eye

H21.552 Recession of chamber angle, left eye

H21.553 Recession of chamber angle, bilateral

H21.559 Recession of chamber angle, unspecified eye

H40.001 Preglaucoma, unspecified, right eye

H40.002 Preglaucoma, unspecified, left eye

H40.003 Preglaucoma, unspecified, bilateral

H40.009 Preglaucoma, unspecified, unspecified eye

H40.011 Open angle with borderline findings, low risk, right eye

H40.012 Open angle with borderline findings, low risk, left eye

H40.013 Open angle with borderline findings, low risk, bilateral

H40.019 Open angle with borderline findings, low risk, unspecified eye

H40.021 Open angle with borderline findings, high risk, right eye

H40.022 Open angle with borderline findings, high risk, left eye

H40.023 Open angle with borderline findings, high risk, bilateral

H40.029 Open angle with borderline findings, high risk, unspecified eye

H40.031 Anatomical narrow angle, right eye

H40.032 Anatomical narrow angle, left eye

H40.033 Anatomical narrow angle, bilateral

H40.039 Anatomical narrow angle, unspecified eye

H40.041 Steroid responder, right eye

H40.042 Steroid responder, left eye

H40.043 Steroid responder, bilateral

H40.049 Steroid responder, unspecified eye

H40.051 Ocular hypertension, right eye

H40.052 Ocular hypertension, left eye

H40.053 Ocular hypertension, bilateral

H40.059 Ocular hypertension, unspecified eye

H40.061 Primary angle closure without glaucoma damage, right eye

H40.062 Primary angle closure without glaucoma damage, left eye

H40.063 Primary angle closure without glaucoma damage, bilateral

H40.069 Primary angle closure without glaucoma damage, unspecified eye

H40.10x0 Unspecified open-angle glaucoma, stage unspecified

H40.10x1 Unspecified open-angle glaucoma, mild stage

H40.10x2 Unspecified open-angle glaucoma, moderate stage

H40.10x3 Unspecified open-angle glaucoma, severe stage

H40.10x4 Unspecified open-angle glaucoma, indeterminate stage

H40.1110: Primary open-angle glaucoma, right eye, stage unspecified

H40.1111: Primary open-angle glaucoma, right eye, mild stage

H40.1112: Primary open-angle glaucoma, right eye, moderate stage

H40.1113: Primary open-angle glaucoma, right eye, severe stage

H40.1114: Primary open-angle glaucoma, right eye, indeterminate stage

H40.1120: Primary open-angle glaucoma, left eye, stage unspecified

H40.1121: Primary open-angle glaucoma, left eye, mild stage

H40.1122: Primary open-angle glaucoma, left eye, moderate stage

H40.1123: Primary open-angle glaucoma, left eye, severe stage

H40.1124: Primary open-angle glaucoma, left eye, indeterminate stage

H40.1130: Primary open-angle glaucoma, bilateral, stage unspecified

H40.1131: Primary open-angle glaucoma, bilateral, mild stage

H40.1132: Primary open-angle glaucoma, bilateral, moderate stage

H40.1133: Primary open-angle glaucoma, bilateral, severe stage

H40.1134: Primary open-angle glaucoma, bilateral, indeterminate stage

H40.1190: Primary open-angle glaucoma, unspecified eye, stage unspecified

H40.1191: Primary open-angle glaucoma, unspecified eye, mild stage

H40.1192: Primary open-angle glaucoma, unspecified eye, moderate stage

H40.1193: Primary open-angle glaucoma, unspecified eye, severe stage

H40.1194: Primary open-angle glaucoma, unspecified eye, indeterminate stage

H40.1210 Low-tension glaucoma, right eye, stage unspecified

H40.1211 Low-tension glaucoma, right eye, mild stage

H40.1212 Low-tension glaucoma, right eye, moderate stage

H40.1213 Low-tension glaucoma, right eye, severe stage

H40.1214 Low-tension glaucoma, right eye, indeterminate stage

H40.1220 Low-tension glaucoma, left eye, stage unspecified

H40.1221 Low-tension glaucoma, left eye, mild stage

H40.1222 Low-tension glaucoma, left eye, moderate stage

H40.1223 Low-tension glaucoma, left eye, severe stage

H40.1224 Low-tension glaucoma, left eye, indeterminate stage

H40.1230 Low-tension glaucoma, bilateral, stage unspecified

H40.1231 Low-tension glaucoma, bilateral, mild stage

H40.1232 Low-tension glaucoma, bilateral, moderate stage

H40.1233 Low-tension glaucoma, bilateral, severe stage

H40.1234 Low-tension glaucoma, bilateral, indeterminate stage

H40.1290 Low-tension glaucoma, unspecified eye, stage unspecified

H40.1291 Low-tension glaucoma, unspecified eye, mild stage

H40.1292 Low-tension glaucoma, unspecified eye, moderate stage

H40.1293 Low-tension glaucoma, unspecified eye, severe stage

H40.1294 Low-tension glaucoma, unspecified eye, indeterminate stage

H40.1310 Pigmentary glaucoma, right eye, stage unspecified

H40.1311 Pigmentary glaucoma, right eye, mild stage

H40.1312 Pigmentary glaucoma, right eye, moderate stage

H40.1313 Pigmentary glaucoma, right eye, severe stage

H40.1314 Pigmentary glaucoma, right eye, indeterminate stage

H40.1320 Pigmentary glaucoma, left eye, stage unspecified

H40.1321 Pigmentary glaucoma, left eye, mild stage

H40.1322 Pigmentary glaucoma, left eye, moderate stage

H40.1323 Pigmentary glaucoma, left eye, severe stage

H40.1324 Pigmentary glaucoma, left eye, indeterminate stage

H40.1330 Pigmentary glaucoma, bilateral, stage unspecified

H40.1331 Pigmentary glaucoma, bilateral, mild stage

H40.1332 Pigmentary glaucoma, bilateral, moderate stage

H40.1333 Pigmentary glaucoma, bilateral, severe stage

H40.1334 Pigmentary glaucoma, bilateral, indeterminate stage

H40.1390 Pigmentary glaucoma, unspecified eye, stage unspecified

H40.1391 Pigmentary glaucoma, unspecified eye, mild stage

H40.1392 Pigmentary glaucoma, unspecified eye, moderate stage

H40.1393 Pigmentary glaucoma, unspecified eye, severe stage

H40.1394 Pigmentary glaucoma, unspecified eye, indeterminate stage

H40.1410 Capsular glaucoma with pseudoexfoliation of lens, right eye, stage unspecified

H40.1411 Capsular glaucoma with pseudoexfoliation of lens, right eye, mild stage

H40.1412 Capsular glaucoma with pseudoexfoliation of lens, right eye, moderate stage

H40.1413 Capsular glaucoma with pseudoexfoliation of lens, right eye, severe stage

H40.1414 Capsular glaucoma with pseudoexfoliation of lens, right eye, indeterminate stage

H40.1420 Capsular glaucoma with pseudoexfoliation of lens, left eye, stage unspecified

H40.1421 Capsular glaucoma with pseudoexfoliation of lens, left eye, mild stage

H40.1422 Capsular glaucoma with pseudoexfoliation of lens, left eye, moderate stage

H40.1423 Capsular glaucoma with pseudoexfoliation of lens, left eye, severe stage

H40.1424 Capsular glaucoma with pseudoexfoliation of lens, left eye, indeterminate stage

H40.1430 Capsular glaucoma with pseudoexfoliation of lens, bilateral, stage unspecified

H40.1431 Capsular glaucoma with pseudoexfoliation of lens, bilateral, mild stage

H40.1432 Capsular glaucoma with pseudoexfoliation of lens, bilateral, moderate stage

H40.1433 Capsular glaucoma with pseudoexfoliation of lens, bilateral, severe stage

H40.1434 Capsular glaucoma with pseudoexfoliation of lens, bilateral, indeterminate stage

H40.1490 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, stage unspecified

H40.1491 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, mild stage

H40.1492 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, moderate stage

H40.1493 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, severe stage

H40.1494 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, indeterminate stage

H40.20x0 Unspecified primary angle-closure glaucoma, stage unspecified

H40.20x1 Unspecified primary angle-closure glaucoma, mild stage

H40.20x2 Unspecified primary angle-closure glaucoma, moderate stage

H40.20x3 Unspecified primary angle-closure glaucoma, severe stage

H40.20x4 Unspecified primary angle-closure glaucoma, indeterminate stage

H40.211 Acute angle-closure glaucoma, right eye

H40.212 Acute angle-closure glaucoma, left eye

H40.213 Acute angle-closure glaucoma, bilateral

H40.219 Acute angle-closure glaucoma, unspecified eye

H40.2210 Chronic angle-closure glaucoma, right eye, stage unspecified

H40.2211 Chronic angle-closure glaucoma, right eye, mild stage

H40.2212 Chronic angle-closure glaucoma, right eye, moderate stage

H40.2213 Chronic angle-closure glaucoma, right eye, severe stage

H40.2214 Chronic angle-closure glaucoma, right eye, indeterminate stage

H40.2220 Chronic angle-closure glaucoma, left eye, stage unspecified

H40.2221 Chronic angle-closure glaucoma, left eye, mild stage

H40.2222 Chronic angle-closure glaucoma, left eye, moderate stage

H40.2223 Chronic angle-closure glaucoma, left eye, severe stage

H40.2224 Chronic angle-closure glaucoma, left eye, indeterminate stage

H40.2230 Chronic angle-closure glaucoma, bilateral, stage unspecified

H40.2231 Chronic angle-closure glaucoma, bilateral, mild stage

H40.2232 Chronic angle-closure glaucoma, bilateral, moderate stage

H40.2233 Chronic angle-closure glaucoma, bilateral, severe stage

H40.2234 Chronic angle-closure glaucoma, bilateral, indeterminate stage

H40.2290 Chronic angle-closure glaucoma, unspecified eye, stage unspecified

H40.2291 Chronic angle-closure glaucoma, unspecified eye, mild stage

H40.2292 Chronic angle-closure glaucoma, unspecified eye, moderate stage

H40.2293 Chronic angle-closure glaucoma, unspecified eye, severe stage

H40.2294 Chronic angle-closure glaucoma, unspecified eye, indeterminate stage

H40.231 Intermittent angle-closure glaucoma, right eye

H40.232 Intermittent angle-closure glaucoma, left eye

H40.233 Intermittent angle-closure glaucoma, bilateral

H40.239 Intermittent angle-closure glaucoma, unspecified eye

H40.241 Residual stage of angle-closure glaucoma, right eye

H40.242 Residual stage of angle-closure glaucoma, left eye

H40.243 Residual stage of angle-closure glaucoma, bilateral

H40.249 Residual stage of angle-closure glaucoma, unspecified eye

H40.30X0 Glaucoma secondary to eye trauma, unspecified eye, stage unspecified

H40.30X1 Glaucoma secondary to eye trauma, unspecified eye, mild stage

H40.30X2 Glaucoma secondary to eye trauma, unspecified eye, moderate stage

H40.30X3 Glaucoma secondary to eye trauma, unspecified eye, severe stage

H40.30X4 Glaucoma secondary to eye trauma, unspecified eye, indeterminate stage

H40.31x0 Glaucoma secondary to eye trauma, right eye, stage unspecified

H40.31x1 Glaucoma secondary to eye trauma, right eye, mild stage

H40.31x2 Glaucoma secondary to eye trauma, right eye, moderate stage

H40.31x3 Glaucoma secondary to eye trauma, right eye, severe stage

H40.31x4 Glaucoma secondary to eye trauma, right eye, indeterminate stage

H40.32x0 Glaucoma secondary to eye trauma, left eye, stage unspecified

H40.32x1 Glaucoma secondary to eye trauma, left eye, mild stage

H40.32x2 Glaucoma secondary to eye trauma, left eye, moderate stage

H40.32x3 Glaucoma secondary to eye trauma, left eye, severe stage

H40.32x4 Glaucoma secondary to eye trauma, left eye, indeterminate stage

H40.33x0 Glaucoma secondary to eye trauma, bilateral, stage unspecified

H40.33x1 Glaucoma secondary to eye trauma, bilateral, mild stage

H40.33x2 Glaucoma secondary to eye trauma, bilateral, moderate stage

H40.33x3 Glaucoma secondary to eye trauma, bilateral, severe stage

H40.33x4 Glaucoma secondary to eye trauma, bilateral, indeterminate stage

H40.40X0 Glaucoma secondary to eye inflammation, unspecified eye, stage unspecified

H40.40X1 Glaucoma secondary to eye inflammation, unspecified eye, mild stage

H40.40X2 Glaucoma secondary to eye inflammation, unspecified eye, moderate stage

H40.40X3 Glaucoma secondary to eye inflammation, unspecified eye, severe stage

H40.40X4 Glaucoma secondary to eye inflammation, unspecified eye, indeterminate stage

H40.41x0 Glaucoma secondary to eye inflammation, right eye, stage unspecified

H40.41x1 Glaucoma secondary to eye inflammation, right eye, mild stage

H40.41x2 Glaucoma secondary to eye inflammation, right eye, moderate stage

H40.41x3 Glaucoma secondary to eye inflammation, right eye, severe stage

H40.41x4 Glaucoma secondary to eye inflammation, right eye, indeterminate stage

H40.42x0 Glaucoma secondary to eye inflammation, left eye, stage unspecified

H40.42x1 Glaucoma secondary to eye inflammation, left eye, mild stage

H40.42x2 Glaucoma secondary to eye inflammation, left eye, moderate stage

H40.42x3 Glaucoma secondary to eye inflammation, left eye, severe stage

H40.42x4 Glaucoma secondary to eye inflammation, left eye, indeterminate stage

H40.43x0 Glaucoma secondary to eye inflammation, bilateral, stage unspecified

H40.43x1 Glaucoma secondary to eye inflammation, bilateral, mild stage

H40.43x2 Glaucoma secondary to eye inflammation, bilateral, moderate stage

H40.43x3 Glaucoma secondary to eye inflammation, bilateral, severe stage

H40.43x4 Glaucoma secondary to eye inflammation, bilateral, indeterminate stage

H40.50X0 Glaucoma secondary to other eye disorders, unspecified eye, stage unspecified

H40.50X1 Glaucoma secondary to other eye disorders, unspecified eye, mild stage

H40.50X2 Glaucoma secondary to other eye disorders, unspecified eye, moderate stage

H40.50X3 Glaucoma secondary to other eye disorders, unspecified eye, severe stage

H40.50X4 Glaucoma secondary to other eye disorders, unspecified eye, indeterminate stage

H40.51x0 Glaucoma secondary to other eye disorders, right eye, stage unspecified

H40.51x1 Glaucoma secondary to other eye disorders, right eye, mild stage

H40.51x2 Glaucoma secondary to other eye disorders, right eye, moderate stage

H40.51x3 Glaucoma secondary to other eye disorders, right eye, severe stage

H40.51x4 Glaucoma secondary to other eye disorders, right eye, indeterminate stage

H40.52x0 Glaucoma secondary to other eye disorders, left eye, stage unspecified

H40.52x1 Glaucoma secondary to other eye disorders, left eye, mild stage

H40.52x2 Glaucoma secondary to other eye disorders, left eye, moderate stage

H40.52x3 Glaucoma secondary to other eye disorders, left eye, severe stage

H40.52x4 Glaucoma secondary to other eye disorders, left eye, indeterminate stage

H40.53x0 Glaucoma secondary to other eye disorders, bilateral, stage unspecified

H40.53x1 Glaucoma secondary to other eye disorders, bilateral, mild stage

H40.53x2 Glaucoma secondary to other eye disorders, bilateral, moderate stage

H40.53x3 Glaucoma secondary to other eye disorders, bilateral, severe stage

H40.53x4 Glaucoma secondary to other eye disorders, bilateral, indeterminate stage

H40.60X0 Glaucoma secondary to drugs, unspecified eye, stage unspecified

H40.60X1 Glaucoma secondary to drugs, unspecified eye, mild stage

H40.60X2 Glaucoma secondary to drugs, unspecified eye, moderate stage

H40.60X3 Glaucoma secondary to drugs, unspecified eye, severe stage

H40.60X4 Glaucoma secondary to drugs, unspecified eye, indeterminate stage

H40.61x0 Glaucoma secondary to drugs, right eye, stage unspecified

H40.61x1 Glaucoma secondary to drugs, right eye, mild stage

H40.61x2 Glaucoma secondary to drugs, right eye, moderate stage

H40.61x3 Glaucoma secondary to drugs, right eye, severe stage

H40.61x4 Glaucoma secondary to drugs, right eye, indeterminate stage

H40.62x0 Glaucoma secondary to drugs, left eye, stage unspecified

H40.62x1 Glaucoma secondary to drugs, left eye, mild stage

H40.62x2 Glaucoma secondary to drugs, left eye, moderate stage

H40.62x3 Glaucoma secondary to drugs, left eye, severe stage

H40.62x4 Glaucoma secondary to drugs, left eye, indeterminate stage

H40.63x0 Glaucoma secondary to drugs, bilateral, stage unspecified

H40.63x1 Glaucoma secondary to drugs, bilateral, mild stage

H40.63x2 Glaucoma secondary to drugs, bilateral, moderate stage

H40.63x3 Glaucoma secondary to drugs, bilateral, severe stage

H40.63x4 Glaucoma secondary to drugs, bilateral, indeterminate stage

H40.811 Glaucoma with increased episcleral venous pressure, right eye

H40.812 Glaucoma with increased episcleral venous pressure, left eye

H40.813 Glaucoma with increased episcleral venous pressure, bilateral

H40.821 Hypersecretion glaucoma, right eye

H40.822 Hypersecretion glaucoma, left eye

H40.823 Hypersecretion glaucoma, bilateral

H40.829 Hypersecretion glaucoma, unspecified eye

H40.831 Aqueous misdirection, right eye

H40.832 Aqueous misdirection, left eye

H40.833 Aqueous misdirection, bilateral

H40.839 Aqueous misdirection, unspecified eye

H40.89 Other specified glaucoma

H40.9 Unspecified glaucoma

H42 Glaucoma in diseases classified elsewhere

H44.511 Absolute glaucoma, right eye

H44.512 Absolute glaucoma, left eye

H44.513 Absolute glaucoma, bilateral

H44.519 Absolute glaucoma, unspecified eye

P15.3 Birth injury to eye

Q15.0 Congenital glaucoma

T85.318A Breakdown (mechanical) of other ocular prosthetic devices, implants and grafts, initial encounter

T85.318D Breakdown (mechanical) of other ocular prosthetic devices, implants and grafts, subsequent encounter

T85.318S Breakdown (mechanical) of other ocular prosthetic devices, implants and grafts, sequela

T85.328A Displacement of other ocular prosthetic devices, implants and grafts, initial encounter

T85.328D Displacement of other ocular prosthetic devices, implants and grafts, subsequent encounter

T85.328S Displacement of other ocular prosthetic devices, implants and grafts, sequela

T85.398A Other mechanical complication of other ocular prosthetic devices, implants and grafts, initial encounter

T85.398D Other mechanical complication of other ocular prosthetic devices, implants and grafts, subsequent encounter

T85.398S Other mechanical complication of other ocular prosthetic devices, implants and grafts, sequela

T86.840 Corneal transplant rejection

T86.841 Corneal transplant failure

T86.848 Other complications of corneal transplant

T86.849 Unspecified complication of corneal transplant

Z94.7 Corneal transplant status

Version Effective Date: 04/02/2018
Version Issued Date: 04/02/2018
Version Reissued Date: N/A

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