What employers should know about ICD-10 codes, eye exams and the tie to wellness

image of this article's author, Chad Prittie
Chad Prittie
Regional Vice President

The term “ICD-10 code” may make your eyes glaze over, but this powerful little acronym is one that can have real cost and wellness implications—and benefits—for employers and members alike.

If you’re not familiar with it, ICD-10 is the World Health Organization’s International Classification of Diseases, Tenth Edition. Admittedly, not the most compelling name. But what’s hidden in that name is a tool that helps eye care providers collaborate and communicate with other healthcare providers. And, it can help employers who supply health benefits to reduce healthcare spending and keep millions of workers healthy.

As the National Eye Institute recognizes May as Healthy Vision Month, we want to give you a closer look at the importance of ICD-10 codes in protecting not only employees’ eyes, but overall health-- and explain how reporting these codes can reduce employers’ healthcare spending.

How the codes work with vision care

When employers know more about their workforce’s health risks, they can adopt and promote programs and add benefits to keep their employees healthy.

During an eye exam, the eye doctor uses ICD-10 codes to record all vision conditions and services. That can include early signs of chronic, life-threatening and costly conditions like diabetes, high blood pressure, high cholesterol and more--uncovered when they can be better managed.

EyeMed then gives clients and their disease management vendors the option to receive this ICD-10 information through HIPAA-compliant methods to help employers improve and expand their wellness and disease-management programs, and empower employees to take charge of their health.

The eye doctor also uses the information to refer the member to his or her primary care physician for medical follow up, if needed.

Why these codes should matter to employers

Here’s a fact that starts to put the importance of the ICD-10 codes in perspective--of the millions of EyeMed members who had an eye exam in 2017, nearly 10% were identified for potentially having a high-risk condition, such as diabetes. (1) That’s a lot of members!

And when you take one example of a disease that can be seen early through eye exams, diabetes, the significance of ICD-10 codes really comes into focus.

Diabetes is rising in prevalence--30 million Americans (1 in 10 adults) have diabetes, and 84 million have prediabetes. (2) The impact is financial, as well as personal. So what do the numbers tell us?

• If current trends continue, one-third of the U.S. will have diabetes by 2050. (3)

• Diabetes costs the economy $265 billion annually (4), $245 billion in healthcare expenses alone, plus $20 billion in absenteeism costs. (5)

• Average medical spending for those with diabetes is $13,700 per year, which is approximately 2.3 times higher than the rest of the population. (5)

• 35% of the cost of diabetes is paid for by private insurance—that’s 1 in 5 healthcare dollars. (5)

So, helping just 1 individual with early detection of diabetes through the relatively inexpensive vision benefit not only helps them with wellness, but can save employers tens of thousands of dollars each year. (6)

What you can do next

It just makes good business sense to make it as easy as possible for your employees to get comprehensive eye exams that could improve medical outcomes and save your company real dollars in healthcare expenses and productivity. It’s exactly why we focus on making vision benefits easy to use.

1. For a quick look at how vision benefits can protect employees—and a company’s bottom line--
download our free Value of Vision whitepaper.

2. If you’re already providing vision benefits for your employees, encourage them to use those benefits. Remind them an annual comprehensive eye exam not only fosters vision health, but can protect their overall health by detecting serious, costly and potentially fatal conditions, early.

3. Then, talk to your vision benefits company about getting reports on your vision members’ ICD-10 codes. Knowledge is power! The more you know about employee health risks, the better you can serve the needs of the people who make your business a success each day.


1. Source: EyeMed book of business data, 2017.
2. National Diabetes Statistics Report. Center for Disease Control and Prevention, 2017.
3. Number of Americans with Diabetes Projected to Double or Triple by 2050. Centers for Disease Control and Prevention, 2010.
4. Witters and Liu, “Diabetes Costs U.S. Economy Estimated $266B Annually.” Gallup-Sharecare Well-Being Index, 2017.
5. American Diabetes Association, 2017.
6. “Invigorating Interest in the Vision Benefit,” NAVCP Medical Advisor Roundtable, 2013