ICD-10 Coding for Geographic Atrophy(H35.31x3, H35.31x4)
Complete ICD-10-CM coding and documentation guide for Geographic Atrophy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Geographic Atrophy
H35.31-H35.32Primary Range
Nonexudative Age-related Macular Degeneration
This range includes codes specific to different stages and characteristics of age-related macular degeneration, including geographic atrophy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H35.31x3 | Dry AMD, advanced atrophic without subfoveal involvement | Use when GA is present without foveal involvement. |
|
| H35.31x4 | Dry AMD, advanced atrophic with subfoveal involvement | Use when GA is present with foveal 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 geographic atrophy
Essential facts and insights about Geographic Atrophy
Primary ICD-10-CM Codes for geographic atrophy
Decision Criteria
clinical Criteria
- RPE atrophy not involving foveal center
Applicable To
- Geographic atrophy sparing the fovea
Excludes
- Wet AMD
- Intermediate AMD
Clinical Validation Requirements
- Sharply demarcated RPE atrophy not involving foveal center
- OCT/FAF confirmation
Code-Specific Risks
- Misclassification if foveal involvement is not properly documented.
Coding Notes
- Ensure documentation specifies absence of foveal involvement.
H35.31x4 - Dry AMD, advanced atrophic with subfoveal involvement
Use when GA is present with foveal involvement.
Applicable To
- Geographic atrophy involving the fovea
Excludes
- Wet AMD
- Intermediate AMD
Clinical Validation Requirements
- GA lesions involving foveal center
- Imaging showing hypertransmission to choroid on OCT
Coding Notes
Document foveal involvement clearly to avoid misclassification.
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.
Intermediate dry AMD
H35.31x2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Geographic Atrophy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H35.31x3.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim rejections.
Mitigation Strategy
Use templates that prompt for laterality., Review documentation for completeness.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on AMD prevalence and treatment.
Mitigation Strategy
Ensure documentation specifies geographic atrophy and its characteristics.
Impact
Lack of imaging evidence for coded GA.
Mitigation Strategy
Ensure all GA diagnoses are supported by OCT/FAF imaging.
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 Geographic Atrophy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Geographic Atrophy
Use these documentation templates to ensure complete and accurate documentation for Geographic Atrophy. These templates include all required elements for proper coding and billing.
New GA diagnosis without foveal involvement
Specialty: OphthalmologyRequired Elements
- Imaging results
- Laterality
- Foveal involvement
- Symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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