ICD-10 Coding for Glaucoma(H40.11X-, H40.22X-)
Complete ICD-10-CM coding and documentation guide for Glaucoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Glaucoma
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H40.11X- | Primary open-angle glaucoma | Use when primary open-angle glaucoma is diagnosed with specific laterality and stage. |
|
| H40.22X- | Chronic angle-closure glaucoma | Use when chronic angle-closure glaucoma is diagnosed with specific laterality and stage. |
|
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 glaucoma
Essential facts and insights about Glaucoma
Primary ICD-10-CM Codes for glaucoma
Decision Criteria
clinical Criteria
- Confirmed diagnosis of primary open-angle glaucoma with specific stage.
Applicable To
- Primary open-angle glaucoma
Excludes
- Secondary open-angle glaucoma
Clinical Validation Requirements
- IOP >21 mmHg
- Open angle on gonioscopy
- Characteristic optic nerve damage
Code-Specific Risks
- Incorrect staging can lead to improper coding.
Coding Notes
- Ensure accurate documentation of laterality and stage.
H40.22X- - Chronic angle-closure glaucoma
Use when chronic angle-closure glaucoma is diagnosed with specific laterality and stage.
Applicable To
- Chronic angle-closure glaucoma
Excludes
- Acute angle-closure glaucoma
Clinical Validation Requirements
- Narrow angles on gonioscopy
- Elevated IOP
- Optic nerve damage
Coding Notes
Document angle status and optic nerve findings.
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 Glaucoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H40.11X-.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always include laterality in documentation., Use templates to ensure completeness.
Impact
Reimbursement: May lead to denied claims or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of healthcare data.
Mitigation Strategy
Always use the most specific code available, including laterality and stage.
Impact
Inadequate documentation of glaucoma stage.
Mitigation Strategy
Use standardized templates to ensure complete documentation.
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 Glaucoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Glaucoma
Use these documentation templates to ensure complete and accurate documentation for Glaucoma. These templates include all required elements for proper coding and billing.
Ophthalmology Progress Note
Specialty: OphthalmologyRequired Elements
- Type of glaucoma
- Laterality
- Stage
- IOP measurements
- Optic nerve status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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