11. ICD-10 Coding - Management of Glaucoma Summer 2026

Diagnosis of glaucoma requires an ______ code

ICD-10

ICD-10 diagnosis requires what?

familiarization with wording

An ICD-10 diagnosis also requires you to stage the glaucoma in each eye. What are the different stages according to ICD-10?

-mild

-moderate

-severe

What is the verbiage for POAG in ICD-10 land?

Primary open-angle glaucoma

What is the verbiage for Normal tension glaucoma in ICD-10 land?

Low-tension glaucoma

What is the verbiage for Ocular hypertension in ICD-10 land?

Ocular hypertension

What is the verbiage for a glaucoma suspect in ICD-10 land?

Open angle with borderline findings

What is the verbiage for an angle closure suspect in ICD-10 land?

narrow anatomical angle

What is the verbiage for primary angle closure patient in ICD-10 land?

Primary angle closure without glaucoma damage

What is the verbiage for a acute angle closure patient in ICD-10 land?

Acute angle closure glaucoma attack

What is the verbiage for intermittent angle closure glaucoma in ICD-10 land?

Intermittent angle closure glaucoma

What is the verbiage for chronic angle closure glaucoma patient in ICD-10 land?

Chronic angle closure glaucoma

What is the verbiage for pigment dispersion syndrome glaucoma in ICD-10 land?

pigmentary glaucoma

What is the verbiage for pseudoexfoliation glaucoma in ICD-10 land?

capsular glaucoma with pseudo-exfoliation of lens

What is the verbiage for steroid-induced glaucoma in ICD-10 land?

Glaucoma secondary to drugs

What is the verbiage for trauma-induced glaucoma in ICD-10 land?

Glaucoma secondary to trauma

What is the verbiage for uveitic glaucoma in ICD-10 land?

Glaucoma secondary to inflammation

What are the glaucoma secondary to other eye disorders according to ICD-10?

-Retinal vascular occlusions

-Diabetes

-Disorders of the IOL

-Neoplasms

What is the verbiage for pigment dispersion syndrome in ICD-10 land?

degeneration of the iris (pigmentary)

What is the verbiage for angle recession in ICD-10 land?

Recession of the angle

What is the verbiage for PXE syndrome in ICD-10 land?

other specified cataract

What is the verbiage for a steroid responder in ICD-10 land?

Steroid responder

What is the GSS staging system used for?

-Staging VF as mild, moderate, or severe

-Setting target pressures

-Disease management

What is Glaucoma Staging for ICD-10 used for?

-Used for billing and coding

-More broad in its staging of mild, moderate, and severe

-Used for all forms of glaucoma

The ICD-10 glaucoma staging system is coded ______ per eye

separately

Describe Mild (Early) Stage Glaucoma as described by ICD-10 Glaucoma Staging System

-"Preperimetric" optic nerve changes consistent ith glaucoma BEFORE VF loss

-After progression is detected with OCT RNFL or GCA

You need to lose ____% of RGCs before change can be detected with a VF

30

Is it beneficial to detect glaucoma in the early (mild) stage?

Yes

What does a VF look like with mild (early) glaucoma as defined by ICD-10?

-Optic nerve abnormalities consistent with glaucoma

-NO visual field abnormalities on any VF test

Describe Moderate Stage Glaucoma as described by ICD-10 Glaucoma Staging System

-Once any significant glaucomatous VF loss occurs, the disease is classified as "moderate"

-Involves only one hemifield (superior or inferior)

-Does not involve fixation

Can a VF be classified as "mild" under GSS and "moderate" under ICD-10?

Yes

What does a VF look like with moderate glaucoma as defined by ICD-10?

-Optic nerve abnormalities consistent with glaucoma

-AND glaucomatous VF abnormalities in ONE hemifield

-NO VF loss within 5º of fixation

Describe Advanced (Late, Severe) Stage Glaucoma as described by ICD-10 Glaucoma Staging System

-Involvement of superior and inferior hemifield

-Loss in 5º of fixation

Can a VF be classified as "moderate" under GSS and "severe" under ICD-10?

Yes

What does a VF look like with advanced glaucoma as defined by ICD-10?

-Optic nerve abnormalities consistent with glaucoma

-AND glaucomatous VF abnormalities in BOTH hemifields

-AND/OR loss within 5º of fixation in at least one hemifield

When to code glaucoma as "Indeterminate stage"?

-VFs not yet done

-VFs consistently unreliable

-Patient incapable of performing a VF d/t IDD, Dementia, or physical limitations

Should you use the "unspecified" ICD-10 code?

NO

Why should you not use UNSPECIFIED for glaucoma ICD-10 coding?

-Stage not recorded in chart

-Stage needs to be documented in the record

REVIEW: What is the ICD-10 code for a glaucoma suspect?

Open angle with borderline findings

What categorizes a glaucoma suspect as LOW RISK?

2 or fewer risk factors

What categorizes a glaucoma suspect as HIGH RISK?

3 or more risk factors

What are the "RISK FACTORS" for OAG Suspect Codes?

-African American or Hispanic Race

-Family hx of glaucoma in 1st degree relative

-Thin CCT

-High IOP

-PXE or PDS

What is the utility for the GSS staging system?

VF interpretation for precise disease staging for disease management and setting target pressures

What is the BASIS for GSS staging?

-Mean Deviation

-Precise involvement of points within fixation (from the decibel plot)

-Number of flagged points on pattern deviation plot, both overall and severe

What is the utility for the ICD-10 coding system?

Diagnosis in EHR, biling to insurance

What is the BASIS for ICD-10 staging?

-Broad defects on pattern deviation plot

-Involvement of one or both hemifields

-Central involvement of flagged points, but no interpretation of dB level