ICD-10 Coding for Papilledema(H47.10, H47.11)
Complete ICD-10-CM coding and documentation guide for Papilledema. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Papilledema
H47.1Primary Range
Disorders of optic nerve, not elsewhere classified
This range includes codes specifically for papilledema and related conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H47.10 | Unspecified papilledema | Use when papilledema is documented but the cause is not specified. |
|
| H47.11 | Papilledema associated with increased intracranial pressure | Use when papilledema is directly linked to increased intracranial pressure. |
|
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 papilledema
Essential facts and insights about Papilledema
Primary ICD-10-CM Codes for papilledema
Decision Criteria
documentation Criteria
- No documented cause of papilledema
Applicable To
- Optic disc swelling without specified cause
Excludes
- Papilledema due to increased intracranial pressure (H47.11)
Clinical Validation Requirements
- Clinical examination showing optic disc swelling
- Absence of documented increased intracranial pressure
Code-Specific Risks
- Risk of undercoding if increased intracranial pressure is present but not documented.
Coding Notes
- Ensure documentation specifies the absence of increased intracranial pressure.
H47.11 - Papilledema associated with increased intracranial pressure
Use when papilledema is directly linked to increased intracranial pressure.
Applicable To
- Optic disc swelling due to increased intracranial pressure
Excludes
- Unspecified papilledema (H47.10)
Clinical Validation Requirements
- Documented increased intracranial pressure via lumbar puncture or imaging
- Clinical signs of optic disc swelling
Coding Notes
Ensure documentation includes evidence of increased intracranial pressure.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Benign intracranial hypertension
G93.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Papilledema to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H47.10.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure all diagnostic tests are documented., Clarify the cause of papilledema in clinical notes.
Impact
Reimbursement: Potential for incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use H47.11 when increased intracranial pressure is confirmed.
Impact
Failure to sequence underlying conditions before papilledema.
Mitigation Strategy
Educate coding staff on proper sequencing rules.
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 Papilledema, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Papilledema
Use these documentation templates to ensure complete and accurate documentation for Papilledema. These templates include all required elements for proper coding and billing.
Papilledema with increased intracranial pressure
Specialty: NeurologyRequired Elements
- Optic disc examination findings
- Lumbar puncture results
- Neuroimaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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