ICD-10 Coding for Ophthalmic Aneurysm(I67.1, H35.042)
Complete ICD-10-CM coding and documentation guide for Ophthalmic Aneurysm. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ophthalmic Aneurysm
I60-I69Primary Range
Cerebrovascular diseases
Includes cerebral aneurysms, such as those affecting the ophthalmic artery.
Other retinal disorders
Includes retinal micro-aneurysms, which are different from cerebral aneurysms.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I67.1 | Cerebral aneurysm, nonruptured | Use for confirmed nonruptured aneurysms of the ophthalmic artery. |
|
| H35.042 | Retinal micro-aneurysm | Use for isolated retinal micro-aneurysms without cerebral involvement. |
|
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 ophthalmic aneurysm
Essential facts and insights about Ophthalmic Aneurysm
Primary ICD-10-CM Codes for ophthalmic aneurysm
Decision Criteria
clinical Criteria
- Presence of aneurysm at the ophthalmic artery confirmed by imaging.
documentation Criteria
- Detailed documentation of aneurysm size, location, and rupture status.
Applicable To
- Aneurysm of ophthalmic artery
Excludes
- Retinal micro-aneurysm (H35.042)
Clinical Validation Requirements
- DSA showing aneurysm morphology at the ophthalmic artery
- CT/MRI indicating aneurysm size and location
Code-Specific Risks
- Misclassification with carotid artery aneurysm (I72.0)
Coding Notes
- Ensure laterality is documented to avoid unspecified codes.
H35.042 - Retinal micro-aneurysm
Use for isolated retinal micro-aneurysms without cerebral involvement.
Applicable To
- Micro-aneurysms on fluorescein angiography
Excludes
- Cerebral aneurysm (I67.1)
Clinical Validation Requirements
- Fluorescein angiography showing retinal micro-aneurysms
Coding Notes
Ensure no cerebral involvement is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Retinal micro-aneurysm
H35.042Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ophthalmic Aneurysm to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I67.1.
Impact
Clinical: Impacts treatment decisions., Regulatory: Leads to unspecified coding., Financial: May result in claim denials.
Mitigation Strategy
Always document left or right side in clinical notes.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data affecting clinical decision-making.
Mitigation Strategy
Use I67.1 for ophthalmic artery aneurysms as it is more specific.
Impact
Use of unspecified codes due to lack of detailed documentation.
Mitigation Strategy
Implement documentation templates that require laterality and specific 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 Ophthalmic Aneurysm, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ophthalmic Aneurysm
Use these documentation templates to ensure complete and accurate documentation for Ophthalmic Aneurysm. These templates include all required elements for proper coding and billing.
Ruptured ophthalmic artery aneurysm with SAH
Specialty: NeurosurgeryRequired Elements
- Aneurysm size and location
- Procedure details
- Post-operative findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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