ICD-10 Coding for Optic Nerve Pallor(H47.291, H47.293)
Complete ICD-10-CM coding and documentation guide for Optic Nerve Pallor. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Optic Nerve Pallor
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H47.291 | Other optic atrophy, right eye | Use when optic nerve pallor is documented with specific laterality and pattern in the right eye. |
|
| H47.293 | Other optic atrophy, bilateral | Use when bilateral optic nerve pallor is documented with specific pattern. |
|
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 optic nerve pallor
Essential facts and insights about Optic Nerve Pallor
Primary ICD-10-CM Codes for optic nerve pallor
Decision Criteria
clinical Criteria
- Documented temporal pallor with RNFL thinning
Applicable To
- Temporal pallor
- Sectoral pallor
Excludes
- Glaucoma with optic atrophy
Clinical Validation Requirements
- Temporal pallor with sharp disc margins
- RNFL thinning on OCT
- RAPD present
Code-Specific Risks
- Confusion with glaucoma-related cupping
Coding Notes
- Ensure laterality and pattern are documented to avoid unspecified coding.
H47.293 - Other optic atrophy, bilateral
Use when bilateral optic nerve pallor is documented with specific pattern.
Applicable To
- Bilateral temporal pallor
Excludes
- Glaucoma with optic atrophy
Clinical Validation Requirements
- Bilateral temporal pallor
- Normal OCT with VEP abnormalities
Coding Notes
Ensure bilateral documentation to avoid unspecified coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Primary open-angle glaucoma
H40.11XDocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Optic Nerve Pallor to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H47.291.
Impact
Clinical: Inaccurate diagnosis recording., Regulatory: Potential audit issues., Financial: Denied claims due to unspecified coding.
Mitigation Strategy
Always include laterality in documentation., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data recording.
Mitigation Strategy
Ensure documentation specifies pallor pattern and absence of cupping.
Impact
Inadequate documentation of optic nerve details can trigger audits.
Mitigation Strategy
Use detailed templates and ensure all required elements are documented.
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 Optic Nerve Pallor, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Optic Nerve Pallor
Use these documentation templates to ensure complete and accurate documentation for Optic Nerve Pallor. These templates include all required elements for proper coding and billing.
Optic nerve pallor in a neuro-ophthalmology setting
Specialty: Neuro-OphthalmologyRequired Elements
- Pallor pattern
- Laterality
- Associated findings
- Etiologic evidence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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