Retinitis Pigmentosa ICD 10 Code

Refresher: What are ICD-10 codes?

ICD-10 is the 10th edition of the International Classification of Diseases, a coding system that classifies diseases and their symptoms. It is a standardized system that has codes for diagnostic purposes [1].

These codes are divided into the following categories:

• ICD-10-CM (Clinical modification)
• ICD-10-PCS (Procedure coding system)

While the former assists with disease diagnosis, the latter is used in in-patient coding procedures. These codes contain information about diseases, their signs, and symptoms, injuries, external causes of injuries/diseases, related health problems, etc.

Using this detailed coding system has enabled medical providers and others to receive reimbursement for certain services once they submit ICD-10-CM codes to the payer. These codes also serve as a justification for all the services patients receive as medically necessary.

What is the ICD-10 Code for retinitis pigmentosa?

The ICD-10 code for retinitis pigmentosa or pigmentary retinal dystrophy is H35.52. The code H35.52 falls under “hereditary retinal dystrophy,” represented by H35.5, which further falls under "Other retinal disorders," represented by H35 [2].

Retinitis pigmentosa or pigmentary retinal dystrophy is a term for eye diseases that affect your retina. Your retina is a light-sensitive tissue layer located at the back of the eye. Due to this genetic disease, the cells in your retina can break down, resulting in the loss of vision.

The table below lists the subcategories of “hereditary retinal dystrophy” represented by H35.5 with retinitis pigmentosa under H35.52.

Retinitis pigmentosa ICD-10 code: H35.52

Retinitis pigmentosa ICD code H35.52 Lookup

There are no subcategories of retinitis pigmentosa under H35.52 as it is a subcategory itself. Hence, below is a table of the ICD-10 “hereditary retinal dystrophy” codes with retinitis pigmentosa under H35.52 [3].

H35.5: Hereditary retinal dystrophy

Types of Pigmentary Retinal Dystrophy Under H35.52

ICD-10 code H35.52 represents retinitis pigmentosa, but there are no subcategories represented by additional codes under it. The disease itself is part of the “hereditary retinal dystrophy" type represented by H35.5.

While there are no types of retinitis pigmentosa, there are other conditions with symptoms strikingly similar to those of this condition. The main symptoms of retinitis pigmentosa include:

• Loss of night vision
• Loss of side vision

Other symptoms include:

• Loss of color vision
• Sensitivity to bright lights

Other retinal dystrophies also include some of the stated symptoms. However, in retinitis pigmentosa, the main pathology has to do with the death of both cone and rod photoreceptors.

Types of Retinitis Pigmentosa Excluded from ICD-10 H35.52

The code ICD-10 H35.52 represents retinitis pigmentosa as an independent disease under “hereditary retinal dystrophy (H35.5).” Since it is a rare disease, there are no additional codes included under H35.52.

Code Q15, which represents other congenital malformations of the eye, is excluded from H35 (other retinal disorders). This is because congenital diseases are those that are present at birth but are not necessarily genetic.

On the other hand, retinitis pigmentosa and other hereditary retinal dystrophy types have genetic causes.

Conclusion

Identifying and diagnosing retinitis pigmentosa can be complicated mainly because it's a rare eye disease. Most people with this disease may have low vision, but some people also go blind.

While there is no cure for retinitis pigmentosa, there are rehabilitation programs and low-vision aids to help people make the most out of their vision.

Early diagnosis and treatment are still necessary to manage the disease and avoid further vision loss. This is where assigning the right code becomes imperative because, without it, the symptoms can get confused with other malformations of the eye.

Determining the right ICD-10 code is the best way to create a treatment plan and implement it immediately. In this case, the right code will ensure that patients are able to live a quality life and make the most out of their remaining vision.

ICD-10 codes for hereditary retinal dystrophy can help doctors reach the right diagnostic conclusion and provide the best care to patients with pigmentary retinal dystrophy.