ICD-10 Coding for Retinal Hemorrhage(H35.60, H35.61, H35.62, H35.63)
Complete ICD-10-CM coding and documentation guide for Retinal Hemorrhage. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Retinal Hemorrhage
H35.6Primary Range
Retinal hemorrhage codes
This range includes codes for retinal hemorrhage with specifications for laterality.
Diabetes with ophthalmic complications
Relevant when retinal hemorrhage is due to diabetic retinopathy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H35.60 | Unspecified retinal hemorrhage | Use when laterality is not specified in the documentation. |
|
| H35.61 | Retinal hemorrhage, right eye | Use when documentation specifies hemorrhage in the right eye. |
|
| H35.62 | Retinal hemorrhage, left eye | Use when documentation specifies hemorrhage in the left eye. |
|
| H35.63 | Retinal hemorrhage, bilateral | Use when documentation specifies hemorrhage in both eyes. |
|
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 retinal hemorrhage
Essential facts and insights about Retinal Hemorrhage
Primary ICD-10-CM Codes for retinal hemorrhage
Decision Criteria
documentation Criteria
- Lack of specified laterality in the medical record.
Applicable To
- Retinal hemorrhage NOS
Excludes
- Vitreous hemorrhage (H43.1-)
Clinical Validation Requirements
- Fundoscopic exam showing retinal bleeding without specified laterality.
Code-Specific Risks
- Risk of under-coding due to lack of specificity.
Coding Notes
- Ensure documentation specifies laterality to avoid using unspecified codes.
H35.61 - Retinal hemorrhage, right eye
Use when documentation specifies hemorrhage in the right eye.
Applicable To
- Retinal hemorrhage affecting the right eye
Excludes
- Vitreous hemorrhage (H43.1-)
Clinical Validation Requirements
- Fundoscopic exam showing retinal bleeding in the right eye.
Coding Notes
Verify laterality in the documentation to ensure correct coding.
H35.62 - Retinal hemorrhage, left eye
Use when documentation specifies hemorrhage in the left eye.
Applicable To
- Retinal hemorrhage affecting the left eye
Excludes
- Vitreous hemorrhage (H43.1-)
Clinical Validation Requirements
- Fundoscopic exam showing retinal bleeding in the left eye.
Coding Notes
Verify laterality in the documentation to ensure correct coding.
H35.63 - Retinal hemorrhage, bilateral
Use when documentation specifies hemorrhage in both eyes.
Applicable To
- Retinal hemorrhage affecting both eyes
Excludes
- Vitreous hemorrhage (H43.1-)
Clinical Validation Requirements
- Fundoscopic exam showing retinal bleeding in both eyes.
Coding Notes
Verify bilateral involvement in the documentation to ensure correct coding.
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 Retinal Hemorrhage to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H35.60.
Impact
Clinical: Inaccurate clinical records., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Implement a checklist for documentation completeness.
Impact
Reimbursement: May lead to denied claims or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always verify and use the specific laterality codes (H35.61, H35.62, H35.63) when available.
Impact
Audits may focus on whether laterality is documented and coded correctly.
Mitigation Strategy
Ensure all documentation includes laterality when applicable.
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 Retinal Hemorrhage, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Retinal Hemorrhage
Use these documentation templates to ensure complete and accurate documentation for Retinal Hemorrhage. These templates include all required elements for proper coding and billing.
Diabetic patient with retinal hemorrhage
Specialty: OphthalmologyRequired Elements
- Chief complaint
- History of present illness
- Fundoscopic exam findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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