Hello and welcome to the Legacy Education ICD-10-CM Guideline Review Series. I am Tiffany Roach, the coding coach, and I will be walking through the ICD-10-CM Guidelines with you. This video will cover the chapter-specific guidelines for Chapter 7, Diseases of the Eye and the Adnexa, represented by categories H00 through H59. This presentation is designed to review the ICD-10-CM guidelines that are effective for both fiscal year 2024 and 2025. There were no changes to the guidelines from fiscal year 2024 to 2025. When coding for glaucoma, you should assign as many codes from category H40 as needed to identify the type of glaucoma, the affected eye, and the glaucoma stage.
When a patient has bilateral glaucoma and both eyes are documented within the same type and same stage, a bilateral code should be assigned, if it's available, with the seventh character to represent the most appropriate stage. If a bilateral code is not available, then you should only report one code for the type of glaucoma with the appropriate seventh character indicating the stage. When bilateral glaucoma is present and each eye has a different stage or type, you should assign the appropriate code for each eye individually.
If codes are not available to distinguish laterality, then you should assign one code for each type of glaucoma with the appropriate seventh character for the stage. When the bilateral glaucoma is present and each eye is documented as different stages and laterality is not available within the code set, You should assign a code for the type of glaucoma for each eye with the appropriate seventh character for the stage. If the patient is admitted with glaucoma and the stage of glaucoma progresses during the admission, then you should only code for the highest stage documented during that admission.
When the stage of glaucoma cannot clinically be determined based on documentation, the seventh character 4 should be assigned. It's important that you do not confuse this with the unspecified codes that represent when there is no documentation regarding the stage of glaucoma. If blindness or low vision of both eyes is documented, but the visual impairment category is not documented, you should assign code H54.3. If blindness or low vision in one eye is documented and the visual impairment category is not documented, then you should assign a code from subcategory H54.6 based on your laterality.
If blindness or low vision is documented without specification of laterality, either one eye or bilateral, then you should assign code H54.7. As always, thank you for supporting us and make sure to stay tuned for new videos in our ICD-10-CM guideline review. Make sure to subscribe to our channel so that you can be in the know of our newest videos that are released.