ICD-10 Coding for Red Eye(H10.1-, H10.011, H57.1)
Complete ICD-10-CM coding and documentation guide for Red Eye. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Red Eye
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H10.1- | Acute atopic conjunctivitis | Use when the patient presents with symptoms of allergic conjunctivitis. |
|
| H10.011 | Acute follicular conjunctivitis, right eye | Use when follicular conjunctivitis is confirmed in the right eye. |
|
| H57.1 | Eye pain | Use when eye pain is present without conjunctivitis. |
|
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 red eye
Essential facts and insights about Red Eye
Primary ICD-10-CM Codes for red eye
Decision Criteria
clinical Criteria
- Presence of bilateral itching and watery discharge
Applicable To
- Allergic conjunctivitis
Excludes
- Chronic conjunctivitis
Clinical Validation Requirements
- Presence of itching and watery discharge
- History of allergies
Code-Specific Risks
- Misclassification if laterality is not documented
Coding Notes
- Ensure laterality is documented to avoid unspecified codes.
H10.011 - Acute follicular conjunctivitis, right eye
Use when follicular conjunctivitis is confirmed in the right eye.
Applicable To
- Follicular conjunctivitis
Excludes
- Chronic follicular conjunctivitis
Clinical Validation Requirements
- Follicles on conjunctival surface
- Unilateral presentation
Coding Notes
Document specific findings like follicles to support this code.
H57.1 - Eye pain
Use when eye pain is present without conjunctivitis.
Applicable To
- Ocular pain
Excludes
- Pain due to foreign body
Clinical Validation Requirements
- Pain without visible conjunctival injection
Coding Notes
Ensure pain is isolated without conjunctivitis for accurate 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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Red Eye to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H10.1-.
Impact
Clinical: Leads to incorrect diagnosis and treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim rejections due to lack of specificity.
Mitigation Strategy
Use structured templates for documentation., Train staff on importance of detailed clinical notes.
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces specificity and accuracy of clinical data.
Mitigation Strategy
Document specific type and laterality of conjunctivitis.
Impact
High risk of audit for using codes like H10.9 without specificity.
Mitigation Strategy
Document specific findings and laterality to support code selection.
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 Red Eye, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Red Eye
Use these documentation templates to ensure complete and accurate documentation for Red Eye. These templates include all required elements for proper coding and billing.
Acute conjunctivitis presentation
Specialty: OphthalmologyRequired Elements
- Onset and duration of symptoms
- Laterality and type of discharge
- Presence of pain or photophobia
- Visual acuity and slit lamp findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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