ICD-10 Coding for Impaired Vision(H54.0, H54.1, H54.2)
Complete ICD-10-CM coding and documentation guide for Impaired Vision. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Impaired Vision
H54.0-H54.7Primary Range
Blindness and low vision
This range covers all degrees of visual impairment, including blindness and low vision, with specific codes for laterality and severity.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H54.0 | Blindness, both eyes | Use when both eyes are blind with visual acuity ≤20/200. |
|
| H54.1 | Blindness, one eye, low vision other eye | Use when one eye is blind and the other has low vision. |
|
| H54.2 | Low vision, both eyes | Use when both eyes have low vision. |
|
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 impaired vision
Essential facts and insights about Impaired Vision
Primary ICD-10-CM Codes for impaired vision
Decision Criteria
clinical Criteria
- Visual acuity ≤20/200 in both eyes
Applicable To
- Blindness in both eyes
Excludes
- Blindness, one eye (H54.1-)
Clinical Validation Requirements
- Visual acuity ≤20/200 in both eyes
Code-Specific Risks
- Ensure documentation supports bilateral blindness.
Coding Notes
- Always verify visual acuity and document appropriately.
H54.1 - Blindness, one eye, low vision other eye
Use when one eye is blind and the other has low vision.
Applicable To
- Blindness in one eye, low vision in the other
Excludes
- Blindness, both eyes (H54.0)
Clinical Validation Requirements
- Visual acuity ≤20/200 in one eye, low vision in the other
Coding Notes
Document specific visual acuity for each eye.
H54.2 - Low vision, both eyes
Use when both eyes have low vision.
Applicable To
- Low vision in both eyes
Excludes
- Blindness, both eyes (H54.0)
Clinical Validation Requirements
- Visual acuity >20/200 but ≤20/70 in both eyes
Coding Notes
Verify visual acuity and document appropriately.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Primary open-angle glaucoma
H40.11-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Impaired Vision to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H54.0.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Increases risk of audit., Financial: Potential for denied claims.
Mitigation Strategy
Always document the underlying cause of vision impairment., Use appropriate ICD-10 codes for underlying conditions.
Impact
Reimbursement: May lead to denied claims or reduced reimbursement., Compliance: Increases risk of audit and non-compliance., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Always use specific codes that reflect documented laterality and severity.
Impact
Using unspecified codes when specific laterality is documented.
Mitigation Strategy
Ensure documentation supports the use of specific codes.
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 Impaired Vision, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Impaired Vision
Use these documentation templates to ensure complete and accurate documentation for Impaired Vision. These templates include all required elements for proper coding and billing.
Patient with asymmetric vision loss
Specialty: OphthalmologyRequired Elements
- Visual acuity for each eye
- Field of vision results
- Underlying cause
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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