ICD-10 Coding for Graves' Ophthalmopathy(E05.00, H05.02)
Complete ICD-10-CM coding and documentation guide for Graves' Ophthalmopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Graves' Ophthalmopathy
E05.00-E05.09Primary Range
Thyrotoxicosis with diffuse goiter
Primary range for Graves' disease with or without ophthalmopathy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E05.00 | Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm | Use when Graves' disease is confirmed with ophthalmopathy symptoms. |
|
| H05.02 | Orbital inflammation, bilateral | Use alongside E05.00 when active inflammation is present. |
|
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 Graves' ophthalmopathy
Essential facts and insights about Graves' Ophthalmopathy
Primary ICD-10-CM Codes for graves ophthalmopathy
Decision Criteria
clinical Criteria
- Documented Graves' disease with ocular findings.
Applicable To
- Graves' disease with ophthalmopathy
Excludes
- Thyrotoxic crisis or storm (E05.01)
Clinical Validation Requirements
- TSH <0.4 mIU/L
- Elevated free T4
- Orbital imaging showing extraocular muscle enlargement
Code-Specific Risks
- Ensure thyroid function tests confirm hyperthyroidism.
Coding Notes
- Ensure documentation of CAS and thyroid function tests.
H05.02 - Orbital inflammation, bilateral
Use alongside E05.00 when active inflammation is present.
Applicable To
- Active inflammation in Graves' ophthalmopathy
Excludes
- Infectious orbital inflammation
Clinical Validation Requirements
- CAS ≥3
- Bilateral involvement
Coding Notes
Link to primary code E05.00 for complete documentation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Orbital inflammation, bilateral
H05.02Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm
E05.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Graves' Ophthalmopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E05.00.
Impact
Clinical: Inadequate assessment of disease status., Regulatory: Non-compliance with documentation standards., Financial: Potential denial of claims due to incomplete documentation.
Mitigation Strategy
Ensure thyroid function tests are ordered and results documented., Use checklists to verify documentation completeness.
Impact
Reimbursement: Potential underpayment due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Include specific codes for ocular symptoms like lid retraction.
Impact
Risk of audits due to missing CAS scores or thyroid function tests.
Mitigation Strategy
Implement routine audits of documentation completeness.
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 Graves' Ophthalmopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Graves' Ophthalmopathy
Use these documentation templates to ensure complete and accurate documentation for Graves' Ophthalmopathy. These templates include all required elements for proper coding and billing.
Active Graves' Ophthalmopathy
Specialty: EndocrinologyRequired Elements
- Thyroid status
- Ocular findings
- CAS score
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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