ICD-10 Coding for Pseudoexfoliation(H40.14-, H25.89)
Complete ICD-10-CM coding and documentation guide for Pseudoexfoliation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pseudoexfoliation
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H40.14- | Capsular glaucoma with pseudoexfoliation of lens | Use when pseudoexfoliation leads to glaucoma. |
|
| H25.89 | Other specified cataract | Use when pseudoexfoliation material is present without 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 pseudoexfoliation glaucoma
Essential facts and insights about Pseudoexfoliation
Primary ICD-10-CM Codes for pseudoexfoliation
Decision Criteria
clinical Criteria
- Presence of pseudoexfoliation material with elevated IOP and optic nerve damage.
Applicable To
- Pseudoexfoliation glaucoma
Excludes
- Primary open-angle glaucoma
- Pigmentary glaucoma
Clinical Validation Requirements
- Elevated intraocular pressure (IOP)
- Glaucomatous optic neuropathy
- Pseudoexfoliation material on lens or angle
Code-Specific Risks
- Incorrect staging or laterality documentation
Coding Notes
- Ensure documentation specifies laterality and stage.
H25.89 - Other specified cataract
Use when pseudoexfoliation material is present without glaucoma.
Applicable To
- Pseudoexfoliation syndrome without glaucoma
Excludes
- Pseudoexfoliation glaucoma
Clinical Validation Requirements
- Pseudoexfoliation material observed without optic nerve damage or visual field loss.
Coding Notes
Ensure no glaucoma is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of glaucoma
Z86.13Differential 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 Pseudoexfoliation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H40.14-.
Impact
Clinical: Misrepresents patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Verify glaucoma status before coding.
Impact
Reimbursement: Incorrect coding can lead to reduced reimbursement., Compliance: May trigger audits if codes are misapplied., Data Quality: Affects accuracy of patient records.
Mitigation Strategy
Ensure documentation specifies whether glaucoma is present.
Impact
Failure to document glaucoma stage or laterality can lead to audits.
Mitigation Strategy
Implement checklist for documentation completeness.
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 Pseudoexfoliation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pseudoexfoliation
Use these documentation templates to ensure complete and accurate documentation for Pseudoexfoliation. These templates include all required elements for proper coding and billing.
Ophthalmology Examination
Specialty: OphthalmologyRequired Elements
- Anterior segment findings
- Posterior segment findings
- Diagnostic studies
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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