ICD-10 Coding for Hypertensive Retinopathy(H35.03)
Complete ICD-10-CM coding and documentation guide for Hypertensive Retinopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypertensive Retinopathy
H35.0-H35.9Primary Range
Disorders of the retina
This range includes codes for hypertensive retinopathy and other retinal disorders.
Hypertensive diseases
This range includes codes for essential hypertension and other hypertensive diseases that may be associated with retinopathy.
Key Information: ICD-10 code for hypertensive retinopathy
Essential facts and insights about Hypertensive Retinopathy
Primary ICD-10-CM Code for hypertensive retinopathy
Decision Criteria
clinical Criteria
- Documented retinal changes due to hypertension.
documentation Criteria
- Specify laterality and grade of retinopathy.
Applicable To
- Retinal changes due to hypertension
Excludes
- Diabetic retinopathy (E11.319)
Clinical Validation Requirements
- Fundoscopy findings such as AV nicking, flame-shaped hemorrhages
- Documentation of blood pressure readings
Code-Specific Risks
- Ensure laterality is specified to avoid unspecified coding.
Coding Notes
- Ensure to document the laterality and specific retinal findings.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Essential (primary) hypertension
I10Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Diabetic retinopathy
E11.319Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypertensive Retinopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H35.03.
Impact
Clinical: Inadequate clinical assessment of hypertension severity., Regulatory: Non-compliance with coding guidelines., Financial: Potential claim denials due to incomplete documentation.
Mitigation Strategy
Include BP readings in all hypertensive retinopathy assessments., Use standardized templates that prompt for BP documentation.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data and statistics.
Mitigation Strategy
Always document and code the laterality of the condition.
Impact
Failure to document laterality can lead to audit findings.
Mitigation Strategy
Implement mandatory fields in EHR for laterality.
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 Hypertensive Retinopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypertensive Retinopathy
Use these documentation templates to ensure complete and accurate documentation for Hypertensive Retinopathy. These templates include all required elements for proper coding and billing.
Hypertensive retinopathy diagnosis
Specialty: OphthalmologyRequired Elements
- Laterality
- Fundoscopy findings
- Blood pressure readings
- Symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Hypertensive Retinopathy? Ask your questions below.