ICD-10 Coding for Drusen(H35.361, H35.313)
Complete ICD-10-CM coding and documentation guide for Drusen. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Drusen
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H35.361 | Degenerative drusen of retina, right eye | Use when drusen are present in the right eye without AMD. |
|
| H35.313 | Nonexudative age-related macular degeneration, bilateral | Use when drusen are associated with AMD, specifying bilateral involvement. |
|
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 drusen
Essential facts and insights about Drusen
Primary ICD-10-CM Codes for drusen
Decision Criteria
clinical Criteria
- Drusen present without signs of AMD.
Applicable To
- Drusen without AMD
Excludes
- Drusen with AMD (H35.31x)
Clinical Validation Requirements
- OCT imaging showing hyperreflective deposits under RPE
Code-Specific Risks
- Incorrectly coding AMD-related drusen as degenerative.
Coding Notes
- Ensure no AMD is documented before using this code.
H35.313 - Nonexudative age-related macular degeneration, bilateral
Use when drusen are associated with AMD, specifying bilateral involvement.
Applicable To
- Intermediate dry AMD with drusen
Excludes
- Degenerative drusen without AMD (H35.36x)
Clinical Validation Requirements
- OCT showing subretinal drusenoid deposits
- Documentation of AMD stage
Coding Notes
Ensure AMD stage is documented.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Drusen to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H35.361.
Impact
Clinical: Inaccurate clinical assessment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always document AMD stage when coding drusen with AMD.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use H35.31x codes for drusen with AMD.
Impact
Using degenerative drusen codes for AMD-related cases.
Mitigation Strategy
Educate staff on correct code usage and documentation requirements.
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 Drusen, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Drusen
Use these documentation templates to ensure complete and accurate documentation for Drusen. These templates include all required elements for proper coding and billing.
Intermediate dry AMD with drusen
Specialty: OphthalmologyRequired Elements
- Laterality
- Drusen size
- AMD stage
- OCT findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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