ICD-10 Coding for Herpes Zoster Ophthalmicus(B02.3, B02.31, B02.33)
Complete ICD-10-CM coding and documentation guide for Herpes Zoster Ophthalmicus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Herpes Zoster Ophthalmicus
B02.3Primary Range
Herpes zoster with ophthalmic complications
This range covers all ophthalmic complications associated with herpes zoster, including specific manifestations like conjunctivitis, keratitis, and iridocyclitis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B02.3 | Herpes zoster with ophthalmic complications | Use when any ophthalmic involvement is present with herpes zoster. |
|
| B02.31 | Herpes zoster conjunctivitis | Use when conjunctivitis is the primary manifestation. |
|
| B02.33 | Herpes zoster keratitis | Use when keratitis is the primary manifestation. |
|
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 herpes zoster ophthalmicus
Essential facts and insights about Herpes Zoster Ophthalmicus
Primary ICD-10-CM Codes for herpes zoster ophthalmicus
Decision Criteria
clinical Criteria
- Presence of vesicular rash in V1 distribution
Applicable To
- Herpes zoster with eye involvement
Excludes
- Herpes simplex (B00.-)
Clinical Validation Requirements
- Presence of vesicular rash in V1 distribution
- PCR confirmation of VZV
Code-Specific Risks
- Risk of underreporting specific manifestations if not documented.
Coding Notes
- Ensure to document specific eye involvement to avoid unspecified coding.
B02.31 - Herpes zoster conjunctivitis
Use when conjunctivitis is the primary manifestation.
Applicable To
- Follicular conjunctivitis with herpes zoster
Clinical Validation Requirements
- Follicular conjunctivitis
- Vesicular rash in V1 distribution
Coding Notes
Ensure conjunctivitis is specifically documented.
B02.33 - Herpes zoster keratitis
Use when keratitis is the primary manifestation.
Applicable To
- Dendritic lesions without terminal bulbs
Clinical Validation Requirements
- Pseudodendrites on fluorescein stain
- Reduced corneal sensation
Coding Notes
Document corneal findings clearly to differentiate from HSV.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Visual field defects
H54.7XDocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Herpes Zoster Ophthalmicus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B02.3.
Impact
Clinical: Leads to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use specific terms like 'keratitis' or 'conjunctivitis'.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Document specific eye involvement and use the corresponding specific code.
Impact
Risk of audits due to unspecified coding.
Mitigation Strategy
Ensure detailed documentation of all clinical findings.
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 Herpes Zoster Ophthalmicus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Herpes Zoster Ophthalmicus
Use these documentation templates to ensure complete and accurate documentation for Herpes Zoster Ophthalmicus. These templates include all required elements for proper coding and billing.
Ophthalmology Progress Note
Specialty: OphthalmologyRequired Elements
- Location of rash
- Ocular manifestations
- Diagnostic tests
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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