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Dry Eye ICD 10 Code
Refresher: What are ICD-10 codes?
ICD-10 refers to the tenth revision of the International Classification of Diseases. These codes are made up of alphanumeric numbers that help to classify and code medical conditions, symptoms, and procedures.
The World Health Organization became responsible for managing the official list of codes after introducing the 10th revision of ICD-10 in 1983. Several countries today use the ICD-10 coding system, but it is modified as per the specific healthcare system requirements of each country.
The U.S. uses ICD-10-CM for disease diagnoses, whereas CM refers to “Clinical Modification.” Coding procedures in inpatient settings are assigned ICD-10-PCS codes. The use of these coding systems can be seen in medical claims and statistics.
The ICD-10 codes provide information about an illness, including where it is present, its severity, and related complexities [1]. However, updating these codes to ensure they reflect the most recent medical developments is necessary.
The ICD-10 codes differ for primary cancers and for metastatic cancers. Today, there are more than 70,000 ICD-10-PCS codes and around 68,000 ICD-10-CM codes used for defining malignant neoplasms [2].
What is the ICD 10 Code for Dry Eye?
The general ICD-10 is H04.12 for primary dry eye syndrome, whereas the secondary dry eye syndrome codes will vary based on specific characteristics and how the condition manifests [3].
Dry eye affects the surface of the eye; ocular irritation caused by decreased tear film production or increased tear film evaporation characterizes it.
It occurs due to various disorders that disrupt the normal functioning of the lacrimal apparatus; these disorders prevent it from maintaining a healthy tear film over the eye. One common factor among these disorders is the loss of water from the tear film, which causes an increase in osmolarity beyond the normal limit of 311 mOsm/L.
This increase in osmolarity connects changes in the lacrimal glands, eyelids, and ocular surface diseases. Moreover, dry eye syndrome may develop or progress due to the loss of water from the tear film.
This progression occurs through four key milestones, each of which contributes to the development and manifestation of the condition.
The first milestone involves the loss of water from the tear film, which causes an elevation in tear film osmolarity and sets the foundation for subsequent changes.
The second milestone or stage sees a decrease in the density of conjunctival goblet cells; these cells are responsible for producing mucus that lubricates the eye. There is also a reduction in corneal glycogen, a source of energy for the cornea.
The third milestone sees an increase in corneal epithelial desquamation, where superficial corneal cells shed. This further compromises the integrity of the ocular surface.
The fourth and final stage is where the cornea-tear interface becomes destabilized. This disruption affects the interaction between the cornea and the tear film, causing ongoing discomfort and irritation.
These milestones showcase how dry eye syndrome progresses with time and highlight the underlying changes occurring within the tear film, conjunctiva, cornea, and ocular surface. Understanding these stages can help healthcare professionals in diagnosing and managing dry eye effectively by using the appropriate ICD-10 codes that fall under this particular illness.
Primary Dry Eye ICD 10 Code: H04.12
The ICD-10 code C18.9 H04.12 refers to a disorder characterized by dryness of the cornea and conjunctiva. It typically occurs due to insufficient tear production, causing symptoms such as a burning sensation and a feeling of foreign body presence in the eyes.
This condition is most common in menopausal and post-menopausal women, often caused by filamentary keratitis or erosion of the corneal and conjunctival epithelium.
Healthcare professionals use the H04.12 code to accurately identify and document cases of primary dry eye; it ensures the right diagnosis, treatment, and reimbursement for the condition. H04.12 is a non-specific code and may be further refined with additional codes that provide a greater level of detail regarding tear film insufficiency and other related disorders within the lacrimal system.
Consistently using ICD-10 codes will aid healthcare professionals in ensuring effective medical record-keeping, research, and the provision of quality care for individuals experiencing primary dry eye.
Primary Dry Eye ICD 10 H04.12 Lookup
Below is a table of the ICD 10 codes for dry eye, classified under H04.12, “Dry eye syndrome”. [4]
H04.12: Dry eye syndrome
Types of Dry Eye Conditions coded under H04.12
The most common types of dry eye conditions that are coded under H04.12 include;
- Tear film insufficiency, NOS
- Corneal and conjunctival dryness
- Filamentary keratitis
- Erosion of the conjunctival and corneal epithelium
- Sensation of a foreign body in the eye
- Burning sensation in the eyes
Dry Eye Conditions Excluded from ICD-10 H04.12
H04: Disorders of the lacrimal system exclude congenital malformations of the lacrimal system. However, no specific dry eye conditions are excluded from CD-10 code H04.12. But you must remember that the code H04.12 represents a general category for dry eye syndrome. Therefore, it may not include all possible subtypes or specific conditions related to dry eye.
Additional codes may be needed in some cases to more precisely describe the condition or identify any associated factors or underlying causes of the disorder. Healthcare professionals can use ICD-10 coding guidelines and documentation requirements to accurately and comprehensively code specific dry eye conditions.
Secondary and Metastatic Dry Eye ICD 10 Code: H04.11, H04.13, H16.2, H16.40, and H16.43
Dry eyes are not a cancer condition and as such, they do not have any metastatic forms. However, there are some secondary dry eye ICD 10 codes that vary based on specific characteristics and where the conditions manifests. For example, the H04.11: Lacrimal keratoconjunctivitis secondary dry eye condition under ICD-10 code refers to the inflammation of the cornea and conjunctiva from lacrimal dysfunction or inadequate tear production is coded under secondary.
H04.13 (Keratoconjunctivitis sicca, not specified as Sjögren's) secondary dry eye code covers the dryness of the cornea and conjunctiva without specific association with Sjögren's syndrome. H16.2 (Other superficial keratitis) secondary dry eye code covers inflammation of the superficial layers of the cornea that is not specified as a particular type or cause.
H16.40 (Unspecified corneal neovascularization) secondary dry eye code represents new blood vessel growth on the cornea without specifying the underlying cause or type. And finally, H16.43 (Peripheral corneal neovascularization) secondary dry eye code indicates the formation of new blood vessels at the periphery of the cornea.
Secondary or Metastatic Dry Eye ICD 10 Code: H04.11, H04.13, H16.2, H16.40, and H16.43 Lookup
The ICD 10 codes for dry eye syndrome refer to dry eye conditions that affect the surface of the eye to cause decreased tear film production or increased tear film evaporation. The secondary dry eye conditions under ICD-10 codes that arise from the primary dry eye conditions include the following:
- Lacrimal keratoconjunctivitis
- Keratoconjunctivitis sicca, not specified as Sjögren's
- Other superficial keratitis
- Unspecified corneal neovascularization
- Peripheral corneal neovascularization
Conclusion
The ICD-10 code for primary dry eye syndrome is H04.12, which represents a general category for dry eye. This code identifies cases of the dry eye characterized by ocular irritation caused by decreased tear film production or increased tear film evaporation. The code helps healthcare professionals accurately diagnose and document primary dry eye, ensuring appropriate treatment and reimbursement. H04.12 is a non-specific code and may require additional codes for further detail.
Furthermore, there are several types of dry eye conditions coded under H04.12, including tear film insufficiency, corneal and conjunctival dryness, filamentary keratitis, erosion of the conjunctival and corneal epithelium, sensation of a foreign body in the eye, and burning sensation in the eyes. These codes provide specific information about the nature and manifestations of dry eye, helping healthcare professionals to code and better understand the condition.
While specific dry eye conditions are not excluded from ICD-10 code H04.12, it is vital to recognize that the code represents a general category for dry eye syndrome. Additional codes may be necessary to accurately describe specific subtypes or conditions related to dry eye. Healthcare professionals can use the ICD-10 coding guidelines and documentation requirements to accurately code specific dry eye conditions and associated factors.