VSP Diabetic Eyecare Plus ProgramSM
The Diabetic Eyecare Plus Program is designed to provide supplemental medical eye care services for members with diabetes, diabetic eye disease, glaucoma, or age-related macular degeneration (AMD). Diabetic Eyecare Plus coverage is secondary to other medical eye insurance coverage that may reimburse you, if you are a participating provider with the patient’s medical plan. Please refer to Coordination of Benefits section for more information.
Covered-in-full Retinal Screening
Covered-in-full retinal screening (use CPT code 92250 and modifier 52) is available to patients who have diabetes but don’t show signs of diabetic eye disease. There is no copay for the member and VSP will reimburse $39.00 or your U&C fees, whichever is lower. Retinal screening (photos) can be billed on the same day as the WellVision® exam, under the Diabetic Eyecare Plus authorization. For additional information, refer to retinal screening in the detailed list of covered services below.
Covered Services for Diabetic Eye Disease
Members with type 1 and type 2 diabetes need an annual eye exam that includes dilation to allow for the most thorough examination of the retina and optic nerve. If diabetic eye disease (e.g., diabetic retinopathy or rubeosis) is detected during a comprehensive exam and follow-up care is needed, additional medical eye care services are available under VSP’s Diabetic Eyecare Plus Program to track and monitor diabetic eye disease progression.
Additional medical eye care services available for patients with diabetes and diabetic eye disease include:
- medical follow-up exams
- fundus photography with interpretation and report
- extended ophthalmoscopy
- scanning computerized ophthalmic diagnostic imaging (SCODI) including optical coherence tomography (OCT)
- remote imaging for detection, monitoring and management of retinal disease
- one additional exam with refraction for changes in vision due to diabetes medication(s).
Covered Services for Glaucoma and AMD
Coverage is also available for VSP members with glaucoma and/or age-related macular degeneration (AMD) including:
- medical follow-up exams
- Scanning computerized ophthalmic diagnostic imaging (SCODI) including optical coherence tomography (OCT)
- visual field and acuity tests
- tonometry (used to monitor and measure intraocular pressure)
- gonioscopy (examines the drainage angle of the eye)
- pachymetry (process of measuring the thickness of the cornea)
Copays
Copays, if required, apply to exams only (92002-92014, 99202-99205, 99211-99215, 99421-99423, 99441-99443). Copays do not apply to additional professional services (e.g., retinal screening). A patient’s copay amount should never exceed your VSP payable fee for the service provided.
Eligibility & Authorization
Check the Patient Record Report to confirm Diabetic Eyecare Plus coverage. Patients don’t need a primary care physician’s referral before their visit. Patients can make appointments or be seen immediately. Refer ineligible patients back to their medical primary care doctors, unless you participate on their medical plan panel. Patients choosing non-covered services should be informed of any out-of-pocket cost and asked to sign the Patient Responsibility Statement prior to receiving services. You can find the form under the Forms section of the Administration menu on VSPOnline on eyefinity.com
Submitting Claims
Enter the specific procedure code and related diagnosis code(s), when completing the claim online or manually on the CMS-1500 Claim Form. For full procedure code descriptions, refer to the Current Procedural Terminology (CPT®) maintained by the American Medical Association (AMA).
Reminders:
- Diabetic Eyecare Plus services must be submitted on a separate authorization from routine vision claims.
- Report only those services appropriate for your licensure and your state’s current regulations.
- Code to the highest degree of specificity when indicating diagnosis.
- When applicable, bill the diagnosis code with the correct eye location: left, right or bilateral.
- If evaluation and management services are performed remotely, bill the CPT code with a GQ or 95 modifier, as appropriate
Note: VSP recognizes but does not currently support Place of Service (POS) code 02 for reporting telehealth services rendered from a distant site except when submitted on paper as a secondary for coordination of benefits. Additionally, VSP recognizes but does not currently support POS code 10 for reporting telehealth services provided in patient’s home.
Modifiers GQ or 95 are used to identify telemedicine services, as appropriate. Modifiers are used for information purposes only.
- Standard timely filing guidelines apply.
- When billing eye exams or other services for patients with diabetes, remember to include code 3072F to indicate no evidence of retinopathy in the prior year, when applicable. Data collection codes, including 3072F, should be billed with a $0.00 amount.
Reimbursement
Reimbursement for eye exams will meet your current VSP Signature Plan payable fees. For retinal screening (photos) you’ll be reimbursed $39.00 or your U&C fees, whichever is lower. Approved additional services are reimbursed at 80% of your U&C fee, up to the VSP Primary EyeCare maximum allowables.
Note: For more information about the Interpretation and Report requirement for medical procedures, refer to Guidelines for the Interpretation and Report of Diagnostic Procedures.
Coordination of Benefits
Coordination of benefits (COB) applies to the payment of medical eyecare benefits when a member is covered under two or more benefit plans. If a member has medical benefits under a medical health insurance plan that you’re contracted with, that plan is primary and VSP is secondary. In the event VSP is the secondary payer, VSP may be billed for the member’s out-of-pocket expenses. Examples are copayments, deductibles, charges for noncovered services, or charges for services not covered in full by the primary carrier. Providers are responsible for verifying coverage, as well as billing the other carrier(s).
See Coordination of Benefits section for more information about how to coordinate benefits.
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Medical Follow-Up Exam |
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92002, 92004, 92012, 92014, 99202 - 99205, 99211 - 99215 |
Service Allowance: Allowable once per 12-month period for patients with type 1 or type 2 diabetes and diabetic retinopathy or rubeosis. Use the diagnosis codes below which include both diabetes and diabetic retinopathy. For rubeosis, include a rubeosis and a 1 or type 2 diabetes diagnosis code. If applicable, bill the diagnosis code with the correct eye location: left, right or bilateral. Type 1 diabetes mellitus with diabetic retinopathy E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema E10.3211 - E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E10.3291 - E10.3299 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E10.3311 - E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E10.3391 - E10.3399 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E10.3411 - E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E10.3491 - E10.3499 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E10.3511 - E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema E10.3521 - E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E10.3531 - E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E10.3541 - E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E10.3551 - E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy E10.3591 - E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema Type 2 diabetes mellitus with diabetic retinopathy E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema E11.3211 - E11.3219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E11.3291 - E11.3299 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E11.3311 - E11.3319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E11.3391 - E11.3399 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E11.3411 - E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E11.3491 - E11.3499 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E11.3511 - E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye E11.3521 - E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E11.3531 - E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E11.3541 - E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E11.3551 - E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy E11.3591 - E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema |
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Rubeosis iridis H21.1X1 Other vascular disorders of iris and ciliary body, right eye (rubeosis iridis) H21.1X2 Other vascular disorders of iris and ciliary body, left eye (rubeosis iridis) H21.1X3 Other vascular disorders of iris and ciliary body, bilateral (rubeosis iridis) Type 1 diabetes mellitus E10.10 Type 1 diabetes mellitus with ketoacidosis without coma* E10.21 Type 1 diabetes mellitus with diabetic nephropathy* E10.22 Type 1 diabetes mellitus with diabetic chronic kidney disease* E10.29 Type 1 diabetes mellitus with other diabetic kidney complication* E10.36 Type 1 diabetes mellitus with diabetic cataract* E10.39 Type 1 diabetes mellitus with other diabetic ophthalmic complication* E10.40 Type 1 diabetes mellitus with diabetic neuropathy, unspecified* E10.41 Type 1 diabetes mellitus with diabetic mononeuropathy* E10.42 Type 1 diabetes mellitus with diabetic polyneuropathy* E10.43 Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy* E10.44 Type 1 diabetes mellitus with diabetic amyotrophy* E10.49 Type 1 diabetes mellitus with other diabetic neurological complication* E10.51 Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene* E10.59 Type 1 diabetes mellitus with other circulatory complications* E10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathy* E10.618 Type 1 diabetes mellitus with other diabetic arthropathy* E10.620 Type 1 diabetes mellitus with diabetic dermatitis* E10.621 Type 1 diabetes mellitus with foot ulcer* E10.622 Type 1 diabetes mellitus with other skin ulcer* E10.628 Type 1 diabetes mellitus with other skin complications* E10.630 Type 1 diabetes mellitus with periodontal disease* E10.638 Type 1 diabetes mellitus with other oral complications* E10.649 Type 1 diabetes mellitus with hypoglycemia without coma* E10.65 Type 1 diabetes mellitus with hyperglycemia* E10.69 Type 1 diabetes mellitus with other specified complication* E10.8 Type 1 diabetes mellitus with unspecified complications* |
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Type 2 diabetes mellitus E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma* E11.10 Type 2 diabetes mellitus with ketoacidosis without coma* E11.21 Type 2 diabetes mellitus with diabetic nephropathy* E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease* E11.29 Type 2 diabetes mellitus with other diabetic kidney complication* E11.36 Type 2 diabetes mellitus with diabetic cataract* E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication* E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecified* E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy* E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy* E11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy* E11.44 Type 2 diabetes mellitus with diabetic amyotrophy* E11.49 Type 2 diabetes mellitus with other diabetic neurological complication* E11.51 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene* E11.59 Type 2 diabetes mellitus with other circulatory complications* E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy* E11.618 Type 2 diabetes mellitus with other diabetic arthropathy* E11.620 Type 2 diabetes mellitus with diabetic dermatitis* E11.621 Type 2 diabetes mellitus with foot ulcer* E11.622 Type 2 diabetes mellitus with other skin ulcer* E11.628 Type 2 diabetes mellitus with other skin complications* E11.630 Type 2 diabetes mellitus with periodontal disease* E11.638 Type 2 diabetes mellitus with other oral complications* E11.649 Type 2 diabetes mellitus with hypoglycemia without coma* E11.65 Type 2 diabetes mellitus with hyperglycemia* E11.69 Type 2 diabetes mellitus with other specified complication* E11.8 Type 2 diabetes mellitus with unspecified complications* *Not billable in primary position |
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92020 |
Gonioscopy Service Allowance: Allowable once per 12-month period for patients with type 1 or type 2 diabetes and rubeosis. Use the diagnosis codes below. Include both rubeosis and diabetes diagnosis codes. Rubeosis iridis H21.1X1 Other vascular disorders of iris and ciliary body, right eye (rubeosis iridis) H21.1X2 Other vascular disorders of iris and ciliary body, left eye (rubeosis iridis) H21.1X3 Other vascular disorders of iris and ciliary body, bilateral (rubeosis iridis) Type 1 diabetes mellitus E10.10 Type 1 diabetes mellitus with ketoacidosis without coma* E10.21 Type 1 diabetes mellitus with diabetic nephropathy* E10.22 Type 1 diabetes mellitus with diabetic chronic kidney disease* E10.29 Type 1 diabetes mellitus with other diabetic kidney complication* E10.36 Type 1 diabetes mellitus with diabetic cataract* E10.39 Type 1 diabetes mellitus with other diabetic ophthalmic complication* E10.40 Type 1 diabetes mellitus with diabetic neuropathy, unspecified* E10.41 Type 1 diabetes mellitus with diabetic mononeuropathy* E10.42 Type 1 diabetes mellitus with diabetic polyneuropathy* E10.43 Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy* E10.44 Type 1 diabetes mellitus with diabetic amyotrophy* E10.49 Type 1 diabetes mellitus with other diabetic neurological complication* E10.51 Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene* E10.59 Type 1 diabetes mellitus with other circulatory complications* E10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathy* E10.618 Type 1 diabetes mellitus with other diabetic arthropathy* E10.620 Type 1 diabetes mellitus with diabetic dermatitis* E10.621 Type 1 diabetes mellitus with foot ulcer* E10.622 Type 1 diabetes mellitus with other skin ulcer* E10.628 Type 1 diabetes mellitus with other skin complications* E10.630 Type 1 diabetes mellitus with periodontal disease* E10.638 Type 1 diabetes mellitus with other oral complications* E10.649 Type 1 diabetes mellitus with hypoglycemia without coma* E10.65 Type 1 diabetes mellitus with hyperglycemia* E10.69 Type 1 diabetes mellitus with other specified complication* E10.8 Type 1 diabetes mellitus with unspecified complications* |
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Type 2 diabetes mellitus E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma * E11.10 Type 2 diabetes mellitus with ketoacidosis without coma* E11.21 Type 2 diabetes mellitus with diabetic nephropathy* E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease* E11.29 Type 2 diabetes mellitus with other diabetic kidney complication* E11.36 Type 2 diabetes mellitus with diabetic cataract* E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication* E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecified* E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy* E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy* E11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy* E11.44 Type 2 diabetes mellitus with diabetic amyotrophy* E11.49 Type 2 diabetes mellitus with other diabetic neurological complication* E11.51 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene* E11.59 Type 2 diabetes mellitus with other circulatory complications* E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy* E11.618 Type 2 diabetes mellitus with other diabetic arthropathy* E11.620 Type 2 diabetes mellitus with diabetic dermatitis* E11.621 Type 2 diabetes mellitus with foot ulcer* E11.622 Type 2 diabetes mellitus with other skin ulcer* E11.628 Type 2 diabetes mellitus with other skin complications* E11.630 Type 2 diabetes mellitus with periodontal disease* E11.638 Type 2 diabetes mellitus with other oral complications* E11.649 Type 2 diabetes mellitus with hypoglycemia without coma* E11.65 Type 2 diabetes mellitus with hyperglycemia* E11.69 Type 2 diabetes mellitus with other specified complication* E11.8 Type 2 diabetes mellitus with unspecified complications* *Not billable in primary position |
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92133 (1x per 12-month period) |
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, bilateral; optic nerve Service Allowance: Allowable once per 12-month period for patients with type 1 or type 2 diabetes and diabetic retinopathy. Use the diagnosis codes below which include diabetes and diabetic retinopathy. Type 1 diabetes mellitus with diabetic retinopathy E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema E10.3211 - E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E10.3291 - E10.3299 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E10.3311 - E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E10.3391 - E10.3399 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema Type 2 diabetes mellitus with diabetic retinopathy E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema E11.3211 - E11.3219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E11.3291 - E11.3299 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E11.3311 - E11.3319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E11.3391 - E11.3399 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema Not billable with either extended ophthalmoscopy (initial or subsequent) or fundus photography. |
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92133 (2x per 12-month period) |
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, bilateral; optic nerve Service Allowance: Allowable twice per 12-month period for patients with type 1or type 2 diabetes and diabetic retinopathy. Use the diagnosis codes below which include diabetes and diabetic retinopathy. Type 1 diabetes mellitus with diabetic retinopathy E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema E10.3411 - E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E10.3491 - E10.3499 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E10.3511 - E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema E10.3521 - E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E10.3531 - E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E10.3541 - E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E10.3551 - E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy E10.3591 - E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema Type 2 diabetes mellitus with diabetic retinopathy E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema E11.3411 - E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E11.3491 - E11.3499 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E11.3511 - E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye E11.3521 - E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E11.3531 - E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E11.3541 - E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E11.3551 - E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy E11.3591 - E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema Not billable with either extended ophthalmoscopy (initial or subsequent) or fundus photography. |
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92134 (1x per 12-month period) |
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, bilateral; retina Service Allowance: Allowable once per 12-month period for patients with type 1 or type 2 diabetes and diabetic retinopathy. Use the diagnosis codes below which include diabetes and diabetic retinopathy. Type 1 diabetes mellitus with diabetic retinopathy E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema E10.3211 - E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E10.3291 - E10.3299 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E10.3311 - E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E10.3391 - E10.3399 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema Type 2 diabetes mellitus with diabetic retinopathy E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema E11.3211 - E11.3219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E11.3291 - E11.3299 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E11.3311 - E11.3319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E11.3391 - E11.3399 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema Not billable with either extended ophthalmoscopy (initial or subsequent) or fundus photography. |
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92134 (2x per 12-month period) |
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, bilateral; retina Service Allowance: Allowable twice per 12-month period for patients with type 1 or type 2 diabetes and diabetic retinopathy. Use the diagnosis codes below which include diabetes and diabetic retinopathy. Type 1 diabetes mellitus with diabetic retinopathy E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema E10.3411 - E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E10.3491 - E10.3499 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E10.3511 - E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema E10.3521 - E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E10.3531 - E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E10.3541 - E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E10.3551 - E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy E10.3591 - E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema Type 2 diabetes mellitus with diabetic retinopathy E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema E11.3411 - E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E11.3491 - E11.3499 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E11.3511 - E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye E11.3521 - E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E11.3531 - E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E11.3541 - E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E11.3551 - E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy E11.3591 - E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema Not billable with either extended ophthalmoscopy (initial or subsequent) or fundus photography. |
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92201 |
Ophthalmoscopy, extended; with retinal drawing and scleral depression of peripheral retinal disease (e.g., for retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral or bilateral Ophthalmoscopy, extended, with drawing of optic nerve or macula (e.g., for glaucoma, macular pathology, tumor) with interpretation and report, unilateral or bilateral Service Allowance Allowable once per 6-month period for patients with type 1 or type 2 diabetes and diabetic retinopathy Use the diagnosis codes below which include diabetes and diabetic retinopathy. Type 1 diabetes mellitus with diabetic retinopathy E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema E10.3211 - E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E10.3291 - E10.3299 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E10.3311 - E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E10.3391 - E10.3399 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E10.3411 - E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E10.3491 - E10.3499 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E10.3511 - E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema E10.3521 - E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E10.3531 - E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E10.3541 - E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E10.3551 - E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy E10.3591 - E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema Type 2 diabetes mellitus with diabetic retinopathy E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema E11.3211 - E11.3219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E11.3291 - E11.3299 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E11.3311 - E11.3319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E11.3391 - E11.3399 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E11.3411 - E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E11.3491 - E11.3499 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E11.3511 - E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye E11.3521 - E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E11.3531 - E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E11.3541 - E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E11.3551 - E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy E11.3591 - E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema Cannot be billed with fundus photography or scanning computerized ophthalmic diagnostic imaging (of optic nerve or retina). |
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92227 |
Remote imaging for detection of retinal disease (e.g., retinopathy in a patient with diabetes) with analysis and report under physician supervision, unilateral or bilateral Allowable once per 12-month period Do not report 92227 in conjunction with 92002-92014, 92133, 92134, 92250, 92228 or with the evaluation and management of the single organ system, the eye, 99202-99350 |
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92228 |
Remote imaging for monitoring and management of active retinal disease (e.g., diabetic retinopathy) with physician review, interpretation and report, unilateral or bilateral Allowable once per 12-month period. Do not report 92228 in conjunction with 92002-92014, 92133, 92134, 922250, 92227 or with the evaluation and management of the single organ system, the eye, 99202-99350 |
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92250 |
Fundus photography with interpretation and report Service Allowance: Allowable once per 6-month period for patients with type 1 or type 2 diabetes and diabetic retinopathy. Use the diagnosis codes below which include diabetes and diabetic retinopathy. If applicable, bill the diagnosis code with the correct eye location: left, right or bilateral. Type 1 diabetes mellitus with diabetic retinopathy E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema E10.3211 - E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E10.3291 - E10.3299 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E10.3311 - E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E10.3391 - E10.3399 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E10.3411 - E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E10.3491 - E10.3499 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E10.3511 - E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema E10.3521 - E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E10.3531 - E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E10.3541 - E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E10.3551 - E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy E10.3591 - E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema Type 2 diabetes mellitus with diabetic retinopathy E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema E11.3211 - E11.3219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E11.3291 - E11.3299 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E11.3311 - E11.3319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E11.3391 - E11.3399 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E11.3411 - E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E11.3491 - E11.3499 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E11.3511 - E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye E11.3521 - E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E11.3531 - E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E11.3541 - E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E11.3551 - E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy E11.3591 - E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema Not covered if extended ophthalmoscopy is provided within six months. |
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92250/52 |
Retinal Screening Covered-in-full retinal screening is available to Signature, Choice and Advantage patients who have diabetes but don’t show signs of diabetic eye disease. There is no copay for the member and VSP will reimburse $39.00 or your U&C fees, whichever is lower. Retinal screening can be billed on the same day as the WellVision® eye exam, under the Diabetic Eyecare Plus authorization Service Allowance: Allowable once per 12-month period. Use CPT code 92250 with modifier 52 Bill diagnosis code Z13.5 in the primary position and diagnosis code E10.9, E11.9 or E13.9 in the secondary position. Z13.5 Encounter for screening for eye and ear disorders E10.9 - Type 1 diabetes mellitus without complications E11.9 - Type 2 diabetes mellitus without complications E13.9 - Other specified diabetes mellitus without complications |
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92499 |
Exam with refraction for diabetic patients only who experience vision shifts of ± 1.00 diopters or greater in at least one eye due to diabetes medications (must be documented in the patient’s file). Cannot be billed with another exam service on the same day. Refraction not reimbursed separately; payment is bundled with exam. Service Allowance: Allowable once per 12-month period for patients with type 1 or type 2 diabetes and diabetic retinopathy or rubeosis. Use the diagnosis codes below which include both diabetes and diabetic retinopathy. For rubeosis, include a rubeosis and a type 1 or type 2 diabetes diagnosis code. If applicable, bill the diagnosis code with the correct eye location: left, right or bilateral. Type 1 or type 2 diabetes with diabetic retinopathy E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema E10.3211 - E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema E10.3291 - E10.3299 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E10.3311 - E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E10.3391 - E10.3399 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E10.3411 - E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E10.3491 - E10.3499 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E10.3511 - E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema E10.3521 - E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E10.3531 - E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E10.3541 - E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E10.3551 - E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy E10.3591 - E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema E11.3291 - E11.3299 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema E11.3391 - E11.3399 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E11.3411 - E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema E11.3491 - E11.3499 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema E11.3511 - E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye E11.3521 - E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula E11.3531 - E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula E11.3541 - E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment E11.3551 - E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy E11.3591 - E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular |
|
99421, 99422, 99423 |
Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days. Allowed for patients with type 1 or type 2 diabetes and diabetic retinopathy or rubeosis, bill appropriate diagnosis code. For rubeosis, include a rubeosis and a 1 or type 2 diabetes diagnosis code |
|
99441, |
Telephone evaluation and management service, for established patient, patient initiated, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment. Allowed for patients with type 1 or type 2 diabetes and diabetic retinopathy or rubeosis, bill appropriate diagnosis code. For rubeosis, include a rubeosis and a 1 or type 2 diabetes diagnosis code. Do not report these services in conjunction with 99202-99205, 99212-99215, 99241-99245, or 99421-99423 |
|
99446, 99447, 99448, 99449, 99451, 99452 |
Interprofessional telephone/internet assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional. Allowed for patients with type 1 or type 2 diabetes and diabetic retinopathy or rubeosis, bill appropriate diagnosis code. For rubeosis, include a rubeosis and a 1 or type 2 diabetes diagnosis code. |
Covered Services for Members with AMD
Members with AMD and coverage under the Diabetic Eyecare Plus Program are eligible for the services listed below. All services must be billed with appropriate diagnosis codes (see VSP AMD Approved Diagnosis Codes chart below).
VSP AMD Covered Services
|
Service Allowance: Allowable once per 12-month period for patients with AMD. |
|
|---|---|
|
92002, 92004, 92012, 92014, 99202 - 99205, 99211 - 99215 |
Medical follow-up exam |
|
92081-92083* |
Visual Field Exams |
|
92133 |
SCODI-P (optic nerve) |
|
92134 |
SCODI-P (retina) |
|
92250 |
Fundus photography |
|
99421, 99422, 99423** |
Digital evaluation and management |
|
99441, 99442, 99443 |
Telephone evaluation and management service, established patient, patient initiated |
|
99446, 99447, 99448, 99449, 99451, 99452** |
Interprofessional internet consultation |
*Allowable twice per 12-month period when visual necessity is established.
** Allowable once per 7-day period when visual necessity is established, bill with modifier GQ or 95, as appropriate. If applicable, bill the diagnosis code with the correct eye location: left, right or bilateral.
VSP AMD Approved Diagnosis Codes
Always code to the highest degree of specificity when indicating diagnosis.
If applicable, bill the diagnosis code with the correct eye location: left, right or bilateral.
Provide location modifier when required.
|
AMD services must be billed with one of the following diagnosis codes. |
|
|---|---|
|
H35.30 |
Unspecified macular degeneration |
|
H35.3110 |
Nonexudative age-related macular degeneration, right eye, stage unspecified |
|
H35.3111 |
Nonexudative age-related macular degeneration, right eye, early dry stage |
|
H35.3112 |
Nonexudative age-related macular degeneration, right eye, intermediate dry stage |
|
H35.3113 |
Nonexudative age-related macular degeneration, right eye, advanced atrophic without subfoveal involvement |
|
H35.3114 |
Nonexudative age-related macular degeneration, right eye, advanced atrophic with subfoveal involvement |
|
H35.3120 |
Nonexudative age-related macular degeneration, left eye, stage unspecified |
|
H35.3121 |
Nonexudative age-related macular degeneration, left eye, early dry stage |
|
H35.3122 |
Nonexudative age-related macular degeneration, left eye, intermediate dry stage |
|
H35.3123 |
Nonexudative age-related macular degeneration, left eye, advanced atrophic without subfoveal involvement |
|
H35.3124 |
Nonexudative age-related macular degeneration, left eye, advanced atrophic with subfoveal involvement |
|
H35.3130 |
Nonexudative age-related macular degeneration, bilateral, stage unspecified |
|
H35.3131 |
Nonexudative age-related macular degeneration, bilateral, early dry stage |
|
H35.3132 |
Nonexudative age-related macular degeneration, bilateral, intermediate dry stage |
|
H35.3133 |
Nonexudative age-related macular degeneration, bilateral, advanced atrophic without subfoveal involvement |
|
H35.3134 |
Nonexudative age-related macular degeneration, bilateral, advanced atrophic with subfoveal involvement |
|
H35.3190 |
Nonexudative age-related macular degeneration, unspecified eye, stage unspecified |
|
H35.3191 |
Nonexudative age-related macular degeneration, unspecified eye, early dry stage |
|
H35.3192 |
Nonexudative age-related macular degeneration, unspecified eye, intermediate dry stage |
|
H35.3193 |
Nonexudative age-related macular degeneration, unspecified eye, advanced atrophic without subfoveal involvement |
|
H35.3194 |
Nonexudative age-related macular degeneration, unspecified eye, advanced atrophic with subfoveal involvement |
|
H35.3210 |
Exudative age-related macular degeneration, right eye, stage unspecified |
|
H35.3211 |
Exudative age-related macular degeneration, right eye, with active choroidal neovascularization |
|
H35.3212 |
Exudative age-related macular degeneration, right eye, with inactive choroidal neovascularization |
|
H35.3213 |
Exudative age-related macular degeneration, right eye, with inactive scar |
|
H35.3220 |
Exudative age-related macular degeneration, left eye, stage unspecified |
|
H35.3221 |
Exudative age-related macular degeneration, left eye, with active choroidal neovascularization |
|
H35.3222 |
Exudative age-related macular degeneration, left eye, with inactive choroidal neovascularization |
|
H35.3223 |
Exudative age-related macular degeneration, left eye, with inactive scar |
|
H35.3230 |
Exudative age-related macular degeneration, bilateral, stage unspecified |
|
H35.3231 |
Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization |
|
H35.3232 |
Exudative age-related macular degeneration, bilateral, with inactive choroidal neovascularization |
|
H35.3233 |
Exudative age-related macular degeneration, bilateral, with inactive scar |
|
H35.3290 |
Exudative age-related macular degeneration, unspecified eye, stage unspecified |
|
H35.3291 |
Exudative age-related macular degeneration, unspecified eye, with active choroidal neovascularization |
|
H35.3292 |
Exudative age-related macular degeneration, unspecified eye, with inactive choroidal neovascularization |
|
H35.3293 |
Exudative age-related macular degeneration, unspecified eye, with inactive scar |
|
H35.341 |
Macular cyst, hole, or pseudohole, right eye |
|
H35.342 |
Macular cyst, hole, or pseudohole, left eye |
|
H35.343 |
Macular cyst, hole, or pseudohole, bilateral |
|
H35.351 |
Cystoid macular degeneration, right eye |
|
H35.352 |
Cystoid macular degeneration, left eye |
|
H35.353 |
Cystoid macular degeneration, bilateral |
|
H35.361 |
Drusen (degenerative) of macula, right eye |
|
H35.362 |
Drusen (degenerative) of macula, left eye |
|
H35.363 |
Drusen (degenerative) of macula, bilateral |
|
H35.371 |
Puckering of macula, right eye |
|
H35.372 |
Puckering of macula, left eye |
|
H35.373 |
Puckering of macula, bilateral |
|
H35.381 |
Toxic maculopathy, right eye |
|
H35.382 |
Toxic maculopathy, left eye |
|
H35.383 |
Toxic maculopathy, bilateral |
Covered Services for Members with Glaucoma
Members with glaucoma and coverage under the Diabetic Eyecare Plus Program are eligible for the services listed below. All services must be billed with appropriate diagnosis codes (see VSP Glaucoma Approved Diagnosis Codes chart below).
VSP Glaucoma Covered Services
|
Service Allowance: Allowable once per 12-month period for patients with Glaucoma. |
|
|---|---|
|
92002, 92004, 92012, 92014, 99202 - 99205, 99211 - 99215 |
Medical follow-up exam |
| 76514 | Pachymetry |
| 92020 | Gonioscopy |
|
92081-92083* |
Visual Field Exams |
| 92100 | Tonometry |
|
92133 |
SCODI-P (optic nerve) |
|
92134 |
SCODI-P (retina) |
| 92201-92202 | Extended ophthalmoscopy |
|
92250 |
Fundus photography |
|
99421, 99422, 99423** |
Digital evaluation and management |
|
99441, 99442, 99443 |
Telephone evaluation and management service, established patient, patient initiated |
|
99446, 99447, 99448, 99449, 99451, 99452** |
Interprofessional internet consultation |
*Allowable twice per 12-month period when visual necessity is established.
**Allowable only once per 7-day period when visual necessity is established, bill with modifier GQ or 95, as appropriate. If applicable, bill the diagnosis code with the correct eye location: left, right or bilateral.
VSP Glaucoma Approved Diagnosis Codes
Always code to the highest degree of specificity when indicating diagnosis.
If applicable, bill the diagnosis code with the correct eye location: left, right or bilateral.
Provide location modifier when required.
|
Glaucoma services must be billed with one of the following diagnosis codes |
|
|---|---|
|
H40.001 |
Preglaucoma, unspecified, right eye |
|
H40.002 |
Preglaucoma, unspecified, left eye |
|
H40.003 |
Preglaucoma, unspecified, bilateral |
|
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 |
|
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 |
|
H40.031 |
Anatomical narrow angle, right eye |
|
H40.032 |
Anatomical narrow angle, left eye |
|
H40.033 |
Anatomical narrow angle, bilateral |
|
H40.041 |
Steroid responder, right eye |
|
H40.042 |
Steroid responder, left eye |
|
H40.043 |
Steroid responder, bilateral |
|
H40.051 |
Ocular hypertension, right eye |
|
H40.052 |
Ocular hypertension, left eye |
|
H40.053 |
Ocular hypertension, bilateral |
|
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 |
|
H40.10X0 |
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 |
|
H40.1310 |
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 |
|
H40.1410 |
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 |
|
H40.151 |
Residual stage of open-angle glaucoma, right eye |
|
H40.152 |
Residual stage of open-angle glaucoma, left eye |
|
H40.153 |
Residual stage of open-angle glaucoma, bilateral |
|
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 |
|
H40.2210 |
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 |
|
H40.231 |
Intermittent angle-closure glaucoma, right eye |
|
H40.232 |
Intermittent angle-closure glaucoma, left eye |
|
H40.233 |
Intermittent angle-closure glaucoma, bilateral |
|
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 |
|
H40.31X0 |
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 |
|
H40.41X0 |
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 |
|
H40.51X0 |
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 |
|
H40.61X0 |
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 |
|
H40.831 |
Aqueous misdirection, right eye |
|
H40.832 |
Aqueous misdirection, left eye |
|
H40.833 |
Aqueous misdirection, bilateral |
|
H40.89 |
Other specified glaucoma |
|
H40.9 |
Unspecified glaucoma |
|
H42 |
Glaucoma in diseases classified elsewhere |
|
Q15.0 |
Congenital glaucoma |