ICD-10 Coding for Cataract Extraction(H25.811)
Complete ICD-10-CM coding and documentation guide for Cataract Extraction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cataract Extraction
H25-H26Primary Range
Cataract
This range includes codes for different types of cataracts, which are essential for documenting cataract extraction procedures.
Key Information: ICD-10 code for cataract extraction
Essential facts and insights about Cataract Extraction
Primary ICD-10-CM Code for cataract extraction
Decision Criteria
clinical Criteria
- Presence of age-related changes in the lens
Applicable To
- Age-related cataract affecting the right eye
Excludes
- Traumatic cataract (H26.1_)
Clinical Validation Requirements
- Slit lamp examination showing nuclear sclerosis
- Visual acuity testing indicating impairment
Code-Specific Risks
- Incorrect laterality documentation
Coding Notes
- Ensure laterality is documented correctly to avoid coding errors.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Removal of lens material; aspiration technique
66850Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Traumatic cataract, right eye
H26.13Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cataract Extraction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H25.811.
Impact
Clinical: Inaccurate treatment records, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Include laterality in all relevant documentation, Use templates that prompt for laterality
Impact
Reimbursement: Claims may be denied or delayed., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate medical records.
Mitigation Strategy
Always document and code the specific eye affected.
Impact
Failure to document laterality can lead to audit findings.
Mitigation Strategy
Implement a checklist to ensure laterality is documented in all relevant records.
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 Cataract Extraction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cataract Extraction
Use these documentation templates to ensure complete and accurate documentation for Cataract Extraction. These templates include all required elements for proper coding and billing.
Routine Cataract Extraction
Specialty: OphthalmologyRequired Elements
- Visual acuity assessment
- Slit lamp examination
- Patient's functional impairment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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