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BUSINESS: CODING STRATEGY

ICD-FINALLY

Meibomian gland dysfunction is now an official part of ICD-10

It’s about time. There have been a multitude of individuals in nearly the past decade, including this author, who have tried — to no avail — to work with the World Health Organization to include meibomian gland dysfunction (MGD) into the ICD-10 library of diagnosis codes. But, apparently, 2018 is the year of the eyelid. Most of the changes incorporated into the 2019 ICD-10 codes are changes to the eyelid category. The official start of the 2019 ICD-10 codes is Oct. 1, 2018. On this date, those codes become official and available for use on patient claims. However, that doesn’t mean you can just sit back and wait until October. Here are a few steps to make to be prepared.

CONTACT YOUR VENDOR

The first thing that you should be doing is finding out if your EHR vendor automatically updates changes to the ICD-10 or if you have to manually input the changes into your local practice database. Many of you will have to print out new routing slips with the updated ICD-10 codes as well.

KNOW THE CODES

While there are too many to list here, I thought I would outline both the new codes for MGD and point out some new lid groupings that will be important to know.

There are nine new codes for MGD:

H02.881 Meibomian gland dysfunction right upper eyelid

H02.882 Meibomian gland dysfunction right lower eyelid

H02.883 Meibomian gland dysfunction of right eye, unspecified eyelid

H02.884 Meibomian gland dysfunction left upper eyelid

H02.885 Meibomian gland dysfunction left lower eyelid

H02.886 Meibomian gland dysfunction of left eye, unspecified eyelid

H02.889 Meibomian gland dysfunction of unspecified eye, unspecified eyelid

H02.88A Meibomian gland dysfunction right eye, upper and lower eyelids

H02.88B Meibomian gland dysfunction left eye, upper and lower eyelids

While seven of the nine are a familiar format to the past eyelid groupings, two new groupings are introduced. In the past, we haven’t been able to group the upper and lower lids together into a single ICD-10 code. Now we can. The sixth digit “A” represents upper and lower eyelids of the right eye, and “B” represents the upper and lower eyelids of the left eye. If you see a code with a “C” in this position, it represents upper and lower eyelids bilaterally. You will see this change throughout the 2019 ICD-10 codes with respect to eyelid conditions, however the bilateral classification does not apply to MGD, so if the patient has it on all four lids you will have to use both the “A” and “B” codes listed above.

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THE MOMENT HAS ARRIVED

It has been long overdue for these codes to be established in the ICD-10. That the codes exist validates MGD as a condition, formally recognized and classified to be properly coded within our practices as we treat patients with this affliction. OM