ICD-10 Coding for Pigment Dispersion Syndrome(H21.233, H40.11X_)
Complete ICD-10-CM coding and documentation guide for Pigment Dispersion Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pigment Dispersion Syndrome
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H21.233 | Degeneration of iris (pigmentary), bilateral | Use when bilateral pigment dispersion syndrome is diagnosed without glaucoma. |
|
| H40.11X_ | Open-angle glaucoma with pigment dispersion syndrome | Use when pigment dispersion syndrome progresses to glaucoma. |
|
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 pigment dispersion syndrome
Essential facts and insights about Pigment Dispersion Syndrome
Primary ICD-10-CM Codes for pigment dispersion syndrome
Decision Criteria
clinical Criteria
- Presence of bilateral Krukenberg spindle and trabecular pigmentation
coding Criteria
- Bilateral findings must be documented to use H21.233
Applicable To
- Bilateral pigment dispersion syndrome
Excludes
- Sympathetic uveitis (H44.1-)
Clinical Validation Requirements
- Bilateral Krukenberg spindle
- Mid-peripheral iris transillumination defects
- Homogenous trabecular meshwork pigmentation
Code-Specific Risks
- Incorrectly coding unilateral cases as bilateral
Coding Notes
- Ensure documentation specifies bilateral findings for accurate coding.
H40.11X_ - Open-angle glaucoma with pigment dispersion syndrome
Use when pigment dispersion syndrome progresses to glaucoma.
Applicable To
- Glaucoma secondary to pigment dispersion syndrome
Clinical Validation Requirements
- Increased intraocular pressure
- Optic nerve damage or visual field loss
Coding Notes
Ensure glaucoma staging is documented using the 7th character.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Open-angle glaucoma with PDS
H40.11X_Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Pseudoexfoliation glaucoma
H40.1X2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pigment Dispersion Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H21.233.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or audits.
Mitigation Strategy
Use specific terminology like 'Krukenberg spindle'.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 laterality requirements., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Use H21.231 or H21.232 for unilateral cases.
Impact
Incorrectly coding bilateral when only one eye is affected.
Mitigation Strategy
Ensure laterality is clearly documented in the patient's record.
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 Pigment Dispersion Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pigment Dispersion Syndrome
Use these documentation templates to ensure complete and accurate documentation for Pigment Dispersion Syndrome. These templates include all required elements for proper coding and billing.
Bilateral PDS without glaucoma
Specialty: OphthalmologyRequired Elements
- Patient history
- Slit lamp examination findings
- Gonioscopy results
- Intraocular pressure measurements
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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