What is the ICD-10 code for severe primary open-angle glaucoma?

The ICD-10 code for severe primary open-angle glaucoma is H40.11X3, which requires documentation of specific clinical findings such as a cup-to-disc ratio ≥0.8 and visual field defects.

How do you document diabetic retinopathy without macular edema?

Document diabetic retinopathy without macular edema using ICD-10 code E11.319, ensuring to include retinal examination findings and diabetes type.

ICD-10 Coding for Ophthalmology Conditions(H40.11, E11.319, E11.321)

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Explore detailed ICD-10 coding guidelines for ophthalmology, including primary open-angle glaucoma and diabetic retinopathy. Ensure accurate documentation and compliance.

Also known as:

Eye DisordersVision Problems

Related ICD-10 Code Ranges

Complete code families applicable to Ophthalmology Conditions

H00-H59Primary Range

Diseases of the eye and adnexa

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

Code	Description	When to Use	Key Documentation
E11.319	Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema	Use when diabetic retinopathy is present without macular edema in a Type 2 diabetic patient.	Diagnosis of Type 2 diabetes Retinal examination showing retinopathy

Primary ICD-10-CM Codes

Primary open-angle glaucoma

H40.11

Differential Codes

Alternative codes to consider when ruling out similar conditions

Unspecified glaucomaH40.50

Use only if optic nerve damage is suspected but unconfirmed by imaging.

Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edemaE11.321

Use when macular edema is present alongside retinopathy.

Documentation & Coding Risks

Avoid these common issues when documenting Ophthalmology Conditions.

Omitting laterality in eye condition documentation

Impact

Clinical: Leads to ambiguity in treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials due to incomplete documentation.

Mitigation

Always document which eye is affected., Use appropriate modifiers.

Unbundling of eye examination codes

Impact

Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Violates coding guidelines for bundled services., Data Quality: Results in inaccurate data capture for eye care services.

Mitigation

Use comprehensive eye examination codes instead of separate components.

Incorrect glaucoma staging

Impact

Misclassification of glaucoma severity can lead to audit findings.

Mitigation

Ensure thorough documentation of clinical findings supporting the stage.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with H40.11.

Primary Code

H40.11

Primary open-angle glaucoma

Quick Navigation

ICD-10 codes9

Coding risks3

FAQs2

ICD-10 Coding for Ophthalmology Conditions(H40.11, E11.319, E11.321)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for severe primary open-angle glaucoma?

How do you document diabetic retinopathy without macular edema?

Related condition guides