ICD-10 Coding for Blindness(H54.0, H54.8)
Complete ICD-10-CM coding and documentation guide for Blindness. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Blindness
H54.0-H54.8Primary Range
Blindness and low vision
This range includes codes for various levels of blindness and low vision, including legal blindness.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H54.0 | Blindness, both eyes | Use when both eyes are blind and meet the criteria for blindness. |
|
| H54.8 | Legal blindness, as defined in USA | Use for patients meeting the legal definition of blindness in the USA. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for blindness
Essential facts and insights about Blindness
Primary ICD-10-CM Codes for blindness
Decision Criteria
clinical Criteria
- Bilateral visual acuity of 20/200 or worse.
Applicable To
- Bilateral blindness
Excludes
- Blindness with low vision in one eye (H54.61)
Clinical Validation Requirements
- Visual acuity of 20/200 or worse in both eyes
- Visual field of 20 degrees or less in both eyes
Code-Specific Risks
- Ensure documentation specifies bilateral blindness.
Coding Notes
- Always sequence the underlying cause of blindness first.
H54.8 - Legal blindness, as defined in USA
Use for patients meeting the legal definition of blindness in the USA.
Applicable To
- Legal blindness
Excludes
- Blindness with low vision (H54.61)
Clinical Validation Requirements
- Visual acuity of 20/200 or worse in the better eye
- Visual field of 20 degrees or less in the better eye
Coding Notes
Ensure documentation supports legal blindness criteria.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Blindness in one eye, low vision in other eye
H54.61Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Blindness to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H54.0.
Impact
Clinical: Inaccurate assessment of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Always include visual acuity in patient records., Use standardized tests like Snellen chart.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Increases risk of audits., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Use specific codes that indicate laterality and severity.
Impact
Using unspecified codes when specific codes are available.
Mitigation Strategy
Train staff to use specific codes and document laterality.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Blindness, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Blindness
Use these documentation templates to ensure complete and accurate documentation for Blindness. These templates include all required elements for proper coding and billing.
Bilateral blindness due to glaucoma
Specialty: OphthalmologyRequired Elements
- Visual acuity
- Visual fields
- Etiology
- Category level
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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