ICD-10 Coding for Photophobia(H53.19)
Complete ICD-10-CM coding and documentation guide for Photophobia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Photophobia
H53.1-H53.19Primary Range
Subjective visual disturbances
This range includes codes for various subjective visual disturbances, with H53.19 specifically for photophobia.
Key Information: ICD-10 code for photophobia
Essential facts and insights about Photophobia
Primary ICD-10-CM Code for photophobia
Decision Criteria
clinical Criteria
- Photophobia without structural ocular pathology
coding Criteria
- Primary symptom of light sensitivity
documentation Criteria
- Explicit mention of 'photophobia' in clinical notes
Applicable To
- Photophobia
Clinical Validation Requirements
- Explicit documentation of 'photophobia' or 'light-induced pain'
- Absence of structural ocular pathology explaining symptoms
- Association with neurological conditions (e.g., migraine, TBI)
Code-Specific Risks
- Confusion with H53.149 for visual discomfort
- Incorrect sequencing with related conditions
Coding Notes
- Ensure precise documentation of photophobia and its impact on daily activities.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Photophobia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H53.19.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Educate providers on correct terminology., Use templates that prompt for specific terms.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 coding standards., Data Quality: Inaccurate data on patient conditions.
Mitigation Strategy
Use H53.19 specifically for photophobia, not H53.149.
Impact
Using H53.149 instead of H53.19 for photophobia.
Mitigation Strategy
Regular training on ICD-10 updates and coding guidelines.
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 Photophobia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Photophobia
Use these documentation templates to ensure complete and accurate documentation for Photophobia. These templates include all required elements for proper coding and billing.
Photophobia in a migraine patient
Specialty: NeurologyRequired Elements
- Patient description of photophobia
- Associated conditions
- Impact on daily activities
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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