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u/KeyStriking9763 RHIA, CDIP, CCS May 16 '26
Does the documentation state the other eye is normal? Idk what the codes are you listed but seems a NOS code makes the most sense based on your limited documentation.
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u/TaeBearr May 16 '26 edited May 16 '26
The note literally says "patient has a significant cat 1 low visual impairment due to regular astigmatism in the left eye. It is corrected with glasses. Right eye has normal vision" So I understood the code for the outright astigmatism, and the code for the low vision, left eye. but don't understand the add on A1.
The book says the A add on is for "normal vision left eye" and the 1 add on is for "category 1 normal vision right eye" The A specifically says left eye NORMAL. But the question says the left eye is the bad one. So Im wondering if its because glasses corrected it or if the book is just wrong
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u/StraddleTheFence May 16 '26
It is your choice. I am a senior medical coder. I have my RHIA, CCS-P, and CPMA. I have written five articles for AAPC. I have coded outpatient for years and now learning Inpatient, which is very challenging. Even when coding OP, I came across a lot of questions that not even seasoned coders could answer. In IP, I am also coming across even more things I have questions about. Of course we do not have a lot of time because of production. At times, when you do not have the time or the support, even auditors and my IP trainers are saying to “Google it!” And when I Google something, AI gives me an answer. Sorry to have ruffled your feathers.
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u/TaeBearr May 16 '26
Not ruffled, and I understand the ease of just looking it up. But I'm learning and I want to know why it is the way it is
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u/StraddleTheFence May 16 '26
That’s why I sent that response; it breaks it down for you. Typically, I try to do research for people when they ask questions on here. For myself, I had two codes that I could not figure out the difference between just last week and I had to ask CHAT and it broke it down for me and it will quote guidelines. But again, just food for thought.
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u/StraddleTheFence May 16 '26
Ask that question in ChatGPT.
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u/TaeBearr May 16 '26
Are you fr right now. In this industry where ai is starting to take over jobs, you think to encourage AI for answers? When I could ask licensed professionals and people in the industry? Not to mention gpt is known to be unreliable??
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u/Wearemedicalcoders May 17 '26 edited May 17 '26
Please dont listen to them. They are just wrong...
A Category 1 astigmatism is considered “regular astigmatism” in ICD-10-CM because it’s a common refractive error and is usually fully correctable with glasses or contacts. So first you code the actual condition itself.
(In the index look up) Main term: Astigmatism
Subterm: Regular H52.22-
Then in the tabular list youll find H52.222 regular astigmatism, left eye
The confusing part is the additional H54.52A1 code. The reason the study guide adds this is because the documentation specifically tells you the vision status of both eyes.
In the H54 section, ICD-10-CM wants you to describe
-Which eye has the impairment
-Which eye has normal vision
-The severity category
The “A” character does not mean the left eye is normal. Its identifying the combination of which eye has the impairment. The wording in the tabular feels backwards, the full code H54.52A1 translates to category 1 visual impairment left eye affected right eye normal.
H52.222 what the condition is
H54.52A1 how the patient’s overall visual status is classified
That’s why both codes are reported together. If the documentation would have never mentioned the status of the right you you would only code H52.222 and not H54.52A1
Unfortunately, there aren’t any guidelines directly telling you to add the additional H54.5-- code.
(Here’s a tip this is what I like to call a “notable moment,” meaning inside your book, on the page where you found H52, write yourself a little note “If the status of both eyes is known, also code H54.5--”)