The H10-H11 range in ICD-10 covers disorders of the conjunctiva, the thin, clear tissue covering the front of the eye and the inside of the eyelids. These codes include various types of conjunctivitis, other inflammations, degenerations, and other disorders of the conjunctiva. The codes are used to document diagnoses in patient records and to determine appropriate treatment plans.

Key Usage Points:

•H10 codes are used for various forms of conjunctivitis, including acute, chronic, and unspecified.
•H11 codes cover other disorders of the conjunctiva, including degenerations, cysts, and scars.
•Always use the most specific code available based on the documentation.
•Consider additional codes to identify any associated underlying conditions or symptoms.
•Remember to code also any associated tobacco use (Z72.0) or exposure to environmental tobacco smoke (Z77.22).

Coding Guidelines

When to Use:

✓When a patient presents with redness, swelling, or discharge from the eye.
✓When a patient has been diagnosed with a specific type of conjunctivitis, such as allergic conjunctivitis.
✓When a patient has a degenerative disorder of the conjunctiva.
✓When a patient has a noninflammatory disorder of the conjunctiva.

When NOT to Use:

✗When the condition is related to the cornea, not the conjunctiva.
✗When the condition is a systemic disease that affects the eye, not a primary disorder of the conjunctiva.
✗When the patient has a traumatic injury to the eye.
✗When the condition is a disorder of the eyelid, not the conjunctiva.

Code Exclusions

Always verify exclusions in the ICD-10 manual to ensure accurate coding.

Documentation Requirements

Documentation for disorders of the conjunctiva should include the specific diagnosis, the affected eye (right, left, or both), the severity of the condition, and any underlying or associated conditions. The documentation should also include the patient's symptoms, the results of any examinations or tests, and the treatment plan.

Clinical Information:

•Specific diagnosis
•Affected eye
•Severity of the condition
•Underlying or associated conditions

Supporting Evidence:

•Patient's symptoms
•Results of examinations or tests
•Treatment plan

Good Documentation Example:

Patient presents with redness and discharge in the right eye. Diagnosed with acute bacterial conjunctivitis. Prescribed antibiotic eye drops.

Poor Documentation Example:

Patient has red eye.

Common Documentation Errors:

⚠Not specifying the affected eye
⚠Not documenting the severity of the condition
⚠Not including underlying or associated conditions

Range Statistics

Total Codes

Billable

Complexity:

Medium

Primary Use:Clinical Documentation

Chapter:

Coding Complexity

Medium

Complexity Rating

The coding complexity for the H10-H11 range is medium because it requires a detailed understanding of the various types of conjunctivitis and other conjunctival disorders, as well as the ability to accurately document the affected eye, the severity of the condition, and any underlying or associated conditions.

Key Factors:

▸Determining the specific type of conjunctivitis or other conjunctival disorder
▸Identifying the affected eye
▸Assessing the severity of the condition
▸Identifying any underlying or associated conditions

Specialty Focus

The H10-H11 range is primarily used by ophthalmologists and optometrists. However, primary care physicians, pediatricians, and emergency medicine physicians may also use these codes when diagnosing and treating conjunctival disorders.

Primary Specialties:

Ophthalmology

60%

Optometry

30%

Primary Care

10%

Clinical Scenarios:

• A patient presents with redness and itching in both eyes. Diagnosed with allergic conjunctivitis.
• A patient has a persistent red eye. Diagnosed with chronic conjunctivitis.
• A patient has a lump on the conjunctiva. Diagnosed with a conjunctival cyst.
• A patient has a scar on the conjunctiva from a previous injury. Documented as a conjunctival scar.

Resources & References

There are many resources available for coding disorders of the conjunctiva, including the official ICD-10 guidelines, clinical reference books, and educational materials from professional coding organizations.

Official Guidelines:

ICD-10-CM Official Guidelines for Coding and Reporting
American Academy of Ophthalmology ICD-10 coding resources
World Health Organization ICD-10 online browser

Clinical References:

American Academy of Ophthalmology clinical guidelines
ClinicalKey Ophthalmology reference books

Educational Materials:

American Health Information Management Association coding resources
American Academy of Professional Coders educational materials

Frequently Asked Questions

Can I use a H10-H11 code if the patient has a systemic disease that affects the conjunctiva?

No, if the patient has a systemic disease that affects the conjunctiva, you should use the code for the systemic disease, not a H10-H11 code.