ICD-10 Coding for Giant Papillary Conjunctivitis(H10.411, H10.412, H10.413, H10.419)
Complete ICD-10-CM coding and documentation guide for Giant Papillary Conjunctivitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Giant Papillary Conjunctivitis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H10.411 | Chronic giant papillary conjunctivitis, right eye | Use when GPC is confirmed in the right eye with chronic symptoms and papillae >1mm. |
|
| H10.412 | Chronic giant papillary conjunctivitis, left eye | Use when GPC is confirmed in the left eye with chronic symptoms and papillae >1mm. |
|
| H10.413 | Chronic giant papillary conjunctivitis, bilateral | Use when GPC is confirmed in both eyes with chronic symptoms and papillae >1mm. |
|
| H10.419 | Chronic giant papillary conjunctivitis, unspecified eye | Use only when laterality cannot be determined. |
|
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 giant papillary conjunctivitis
Essential facts and insights about Giant Papillary Conjunctivitis
Primary ICD-10-CM Codes for giant papillary conjunctivitis
Decision Criteria
clinical Criteria
- Presence of papillae >1mm on upper tarsal conjunctiva in the right eye.
documentation Criteria
- Documented chronic symptoms and laterality.
Applicable To
- Chronic giant papillary conjunctivitis affecting the right eye
Excludes
- Acute conjunctivitis
- Vernal conjunctivitis
Clinical Validation Requirements
- Papillae >1mm on upper tarsal conjunctiva
- Chronic symptoms (>4 weeks) in the right eye
Code-Specific Risks
- Risk of using unspecified codes when laterality is known.
Coding Notes
- Ensure documentation specifies laterality and chronicity.
H10.412 - Chronic giant papillary conjunctivitis, left eye
Use when GPC is confirmed in the left eye with chronic symptoms and papillae >1mm.
Applicable To
- Chronic giant papillary conjunctivitis affecting the left eye
Excludes
- Acute conjunctivitis
- Vernal conjunctivitis
Clinical Validation Requirements
- Papillae >1mm on upper tarsal conjunctiva
- Chronic symptoms (>4 weeks) in the left eye
Coding Notes
Ensure documentation specifies laterality and chronicity.
H10.413 - Chronic giant papillary conjunctivitis, bilateral
Use when GPC is confirmed in both eyes with chronic symptoms and papillae >1mm.
Applicable To
- Chronic giant papillary conjunctivitis affecting both eyes
Excludes
- Acute conjunctivitis
- Vernal conjunctivitis
Clinical Validation Requirements
- Papillae >1mm on upper tarsal conjunctiva
- Chronic symptoms (>4 weeks) in both eyes
Coding Notes
Ensure documentation specifies laterality and chronicity.
H10.419 - Chronic giant papillary conjunctivitis, unspecified eye
Use only when laterality cannot be determined.
Applicable To
- Chronic giant papillary conjunctivitis when laterality is not specified
Excludes
- Acute conjunctivitis
- Vernal conjunctivitis
Clinical Validation Requirements
- Papillae >1mm on upper tarsal conjunctiva
- Chronic symptoms (>4 weeks)
Coding Notes
Avoid using this code if laterality is known.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Presence of contact lens
Z96.12Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Vernal conjunctivitis
H10.44Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Giant Papillary Conjunctivitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H10.411.
Impact
Clinical: Leads to misdiagnosis and improper treatment., Regulatory: Increases risk of non-compliance with coding standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Use specific terms like 'giant papillary conjunctivitis'., Always document laterality.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Increases risk of audit and non-compliance., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies laterality and use the corresponding specific code.
Impact
Using H10.419 when laterality is known increases audit risk.
Mitigation Strategy
Ensure documentation specifies laterality and use the appropriate specific code.
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 Giant Papillary Conjunctivitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Giant Papillary Conjunctivitis
Use these documentation templates to ensure complete and accurate documentation for Giant Papillary Conjunctivitis. These templates include all required elements for proper coding and billing.
Chronic GPC with contact lens use
Specialty: OphthalmologyRequired Elements
- Chronicity of symptoms
- Laterality
- Papillae size and location
- Contact lens use
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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