ICD-10 Coding for Right Eye Pain(H57.11)
Complete ICD-10-CM coding and documentation guide for Right Eye Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Eye Pain
Key Information: ICD-10 code for right eye pain
Essential facts and insights about Right Eye Pain
Primary ICD-10-CM Code for right eye pain
Decision Criteria
clinical Criteria
- Pain localized to the right eye with no other symptoms indicating a specific condition.
documentation Criteria
- Detailed description of pain onset, characteristics, and associated symptoms.
Applicable To
- Pain in right eye
Excludes
- Pain due to known conditions like glaucoma or uveitis
Clinical Validation Requirements
- Exclusion of foreign body via slit-lamp examination
- Normal intraocular pressure (IOP)
Code-Specific Risks
- Risk of undercoding if underlying cause is known but not documented.
Coding Notes
- Ensure laterality is specified as 'right eye' in documentation.
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 Right Eye Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H57.11.
Impact
Clinical: May lead to misdiagnosis or incomplete treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Include a thorough review of systems., Document all relevant findings from the physical exam.
Impact
Reimbursement: May result in denied claims if not coded correctly., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on patient conditions.
Mitigation Strategy
Add T85.42XA (Pain due to intraocular lens).
Impact
Using G89.11 without documentation of trauma.
Mitigation Strategy
Ensure trauma is clearly documented in the patient's history.
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 Right Eye Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Eye Pain
Use these documentation templates to ensure complete and accurate documentation for Right Eye Pain. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Corneal Abrasion
Specialty: OphthalmologyRequired Elements
- History of Present Illness (HPI)
- Review of Systems (ROS)
- Physical Exam Findings
- Differential Diagnoses
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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