ICD-10 Coding for Central Retinal Vein Occlusion(H34.8110, H34.8132)
Complete ICD-10-CM coding and documentation guide for Central Retinal Vein Occlusion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Central Retinal Vein Occlusion
H34.81-H34.83Primary Range
Retinal vein occlusion
This range includes codes for central retinal vein occlusion, specifying laterality and stage.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H34.8110 | Central retinal vein occlusion, right eye, with macular edema | Use when CRVO with macular edema is confirmed in the right eye. |
|
| H34.8132 | Central retinal vein occlusion, bilateral, stable | Use when CRVO is stable and affects both eyes without edema. |
|
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 central retinal vein occlusion
Essential facts and insights about Central Retinal Vein Occlusion
Primary ICD-10-CM Codes for central retinal vein occlusion
Decision Criteria
clinical Criteria
- Presence of macular edema confirmed by OCT
documentation Criteria
- Right eye involvement clearly documented
Applicable To
- CRVO with macular edema
Excludes
- Branch retinal vein occlusion (H34.83)
Clinical Validation Requirements
- OCT confirmation of macular edema
- Documentation of right eye involvement
Code-Specific Risks
- Incorrect laterality documentation
- Missing macular edema confirmation
Coding Notes
- Ensure documentation specifies macular edema and laterality.
H34.8132 - Central retinal vein occlusion, bilateral, stable
Use when CRVO is stable and affects both eyes without edema.
Applicable To
- Stable CRVO bilaterally
Excludes
- Active macular edema or neovascularization
Clinical Validation Requirements
- Imaging showing no edema or neovascularization
- Bilateral involvement documented
Coding Notes
Ensure bilateral involvement and stability are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Type 2 diabetes mellitus with ophthalmic complications
E11.31Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Central Retinal Vein Occlusion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H34.8110.
Impact
Clinical: Leads to vague clinical records., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Always specify laterality and stage, Use imaging to confirm findings
Impact
Reimbursement: May lead to claim denials or incorrect payment., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Always specify right, left, or bilateral involvement.
Impact
Failure to document laterality can lead to audit issues.
Mitigation Strategy
Implement double-check system for laterality in 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 Central Retinal Vein Occlusion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Central Retinal Vein Occlusion
Use these documentation templates to ensure complete and accurate documentation for Central Retinal Vein Occlusion. These templates include all required elements for proper coding and billing.
CRVO with macular edema
Specialty: OphthalmologyRequired Elements
- Laterality
- Stage
- Macular edema presence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Central Retinal Vein Occlusion? Ask your questions below.