The ICD-10 category H15-H22 covers a range of disorders related to the sclera, cornea, iris, and ciliary body. These codes are used to document various conditions such as scleritis, keratitis, iridocyclitis, and other disorders of the anterior segment of the eye. This category is crucial for ophthalmologists, optometrists, and other eye health specialists to accurately document patient conditions for billing and statistical purposes.

Key Usage Points:

•Always code to the highest level of specificity.
•Use additional codes to identify any associated conditions.
•Codes for postprocedural disorders should be used when these conditions occur as postoperative complications.
•Use a code from H15-H22 only when the condition is diagnosed by the physician as a significant condition which requires medical care.
•Always verify the code in the Tabular List before assigning it.

Coding Guidelines

When to Use:

✓When a patient presents with scleritis.
✓When a patient is diagnosed with keratitis.
✓In cases of iridocyclitis.
✓When a patient has other disorders of the anterior segment of the eye.
✓When a patient has postprocedural disorders of the eye.

When NOT to Use:

✗When the condition is not diagnosed by the physician.
✗When the condition does not require medical care.
✗When the condition is a normal postoperative condition.
✗When the condition is not a significant condition.
✗When the condition is not related to the sclera, cornea, iris, or ciliary body.

Code Exclusions

Always verify the code in the Tabular List before assigning it.

Documentation Requirements

Documentation for codes in the H15-H22 range should include a clear description of the condition, its severity, any associated conditions, and the medical care required. The documentation should be specific and detailed to support the code assigned.

Clinical Information:

•Description of the condition
•Severity of the condition
•Associated conditions
•Medical care required
•Confirmation of diagnosis by the physician

Supporting Evidence:

•Clinical notes
•Lab results
•Imaging results
•Operative reports
•Patient history

Good Documentation Example:

Patient presents with severe scleritis in the right eye, confirmed by clinical examination. Requires medical treatment.

Poor Documentation Example:

Patient has eye inflammation.

Common Documentation Errors:

⚠Not coding to the highest level of specificity
⚠Not using additional codes for associated conditions
⚠Not verifying the code in the Tabular List
⚠Not documenting the condition as diagnosed by the physician
⚠Not documenting the condition as requiring medical care

Range Statistics

Total Codes

152

Billable

Complexity:

Medium

Primary Use:Clinical Documentation

Chapter:

Coding Complexity

Medium

Complexity Rating

The complexity of these codes is medium due to the need to understand the specific conditions covered, code to the highest level of specificity, use additional codes for associated conditions, identify postprocedural disorders, and verify the code in the Tabular List.

Key Factors:

▸Understanding the specific conditions covered by this category
▸Coding to the highest level of specificity
▸Using additional codes for associated conditions
▸Identifying postprocedural disorders
▸Verifying the code in the Tabular List

Specialty Focus

These codes are primarily used by ophthalmologists and optometrists, but can also be used by other healthcare providers who diagnose and treat eye conditions.

Primary Specialties:

Ophthalmology

70%

Optometry

30%

Clinical Scenarios:

• Patient presents with severe scleritis in the right eye.
• Patient is diagnosed with keratitis.
• Patient has iridocyclitis.
• Patient has other disorders of the anterior segment of the eye.
• Patient has postprocedural disorders of the eye.

Resources & References

Resources for these codes include the official ICD-10 coding guidelines, the Tabular List, and clinical reference materials.

Official Guidelines:

ICD-10 coding guidelines
Tabular List
Official coding training materials

Clinical References:

Clinical textbooks
Medical journals
Clinical guidelines

Educational Materials:

Coding training materials
Online coding courses
Coding webinars

Frequently Asked Questions

Can I use a code from H15-H22 for a condition that is not diagnosed by the physician?

No, you should only use a code from H15-H22 when the condition is diagnosed by the physician as a significant condition which requires medical care.