ICD-10 Coding for Eye Injury(S05.0, S05.2)
Complete ICD-10-CM coding and documentation guide for Eye Injury. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Eye Injury
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S05.0 | Injury of conjunctiva and corneal abrasion without foreign body | Use when there is a corneal abrasion without a foreign body present. |
|
| S05.2 | Ocular laceration and rupture with prolapse or loss of intraocular tissue | Use when there is a full-thickness laceration with prolapse of intraocular tissue. |
|
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 eye injury
Essential facts and insights about Eye Injury
Primary ICD-10-CM Codes for eye injury
Decision Criteria
clinical Criteria
- Corneal abrasion confirmed by slit lamp exam
documentation Criteria
- Document laterality and mechanism of injury
Applicable To
- Corneal abrasion
- Conjunctival laceration
Excludes
- Foreign body in cornea (S05.5)
Clinical Validation Requirements
- Slit lamp examination showing corneal abrasion
- Patient history of trauma to the eye
Code-Specific Risks
- Risk of using unspecified codes if laterality is not documented.
Coding Notes
- Ensure to document the mechanism of injury and any protective gear used.
S05.2 - Ocular laceration and rupture with prolapse or loss of intraocular tissue
Use when there is a full-thickness laceration with prolapse of intraocular tissue.
Applicable To
- Full-thickness laceration of the eyeball
Excludes
- Superficial injury of eye (S00.2)
Clinical Validation Requirements
- Positive Seidel test
- Prolapse of intraocular tissue observed
Coding Notes
Document the specific location and depth of the laceration.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Eye Injury to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S05.0.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Increases risk of non-compliance with coding guidelines., Financial: Can result in claim denials or reduced reimbursement.
Mitigation Strategy
Train staff on the importance of documenting the mechanism of injury., Use templates that prompt for this information.
Impact
Reimbursement: May lead to claim denials or reduced payments., Compliance: Increases risk of audits due to lack of specificity., Data Quality: Impacts the accuracy of health records and data analysis.
Mitigation Strategy
Always document laterality and specific injury details to use the most specific code.
Impact
High risk of audit if unspecified codes are used frequently.
Mitigation Strategy
Ensure detailed documentation to support the use of specific codes.
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 Eye Injury, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Eye Injury
Use these documentation templates to ensure complete and accurate documentation for Eye Injury. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Eye Injury
Specialty: OphthalmologyRequired Elements
- Mechanism of injury
- Visual acuity assessment
- Slit lamp examination findings
- Imaging results if applicable
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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