The ICD-10 code range H30-H36 pertains to disorders of the choroid and retina. This includes a variety of conditions such as retinal detachments and breaks, retinal vascular occlusions, hereditary retinal disorders, and inflammatory disorders. These codes are used to specify the type and location of the disorder, and can also indicate if the condition is bilateral or unilateral.

Key Usage Points:

•Always use a higher specificity code if available.
•Bilateral conditions should be coded as such if no unilateral code is available.
•The seventh character is used to indicate the stage of the disorder for certain codes.
•Some codes require additional codes to fully describe the condition.
•Always verify the code in the Tabular List before assigning it.

Coding Guidelines

When to Use:

✓When a patient presents with a retinal detachment.
✓When a patient has a hereditary retinal disorder.
✓When a patient has an inflammatory disorder of the choroid.
✓When a patient has a retinal vascular occlusion.
✓When a patient has a retinal break without detachment.

When NOT to Use:

✗When the condition is not specifically of the choroid or retina.
✗When the condition is due to diabetes mellitus (use E08-E13 with .3).
✗When the condition is due to hypertension (use I67.2-).
✗When the condition is due to sickle-cell disorders (use D57.-).
✗When the condition is due to toxoplasmosis (use B58.01).

Code Exclusions

Always verify exclusions in the Tabular List before assigning a code.

Documentation Requirements

Documentation for disorders of the choroid and retina should include the type of disorder, the location (if applicable), and any relevant clinical information such as the stage of the disorder. Any related symptoms or complications should also be documented.

Clinical Information:

•Type of disorder
•Location of disorder
•Stage of disorder
•Related symptoms
•Any complications

Supporting Evidence:

•Clinical notes
•Imaging results
•Lab results
•Referral notes

Good Documentation Example:

Patient presents with a retinal detachment in the right eye. The detachment is superior with a single break. No other complications are noted.

Poor Documentation Example:

Patient has a retinal problem.

Common Documentation Errors:

⚠Not specifying the type of disorder
⚠Not indicating the location of the disorder
⚠Not documenting any related symptoms or complications
⚠Not using a higher specificity code when available

Range Statistics

Total Codes

150

Billable

Complexity:

Medium

Primary Use:Clinical Documentation

Chapter:

Coding Complexity

Medium

Complexity Rating

Coding for disorders of the choroid and retina can be complex due to the need for high specificity and the use of a seventh character for some codes. Additionally, some conditions require additional codes to fully describe the condition, and exclusions must always be verified.

Key Factors:

▸The need for high specificity
▸The use of a seventh character for some codes
▸The need for additional codes for some conditions
▸The need to verify exclusions

Specialty Focus

These codes are primarily used by ophthalmologists and optometrists. They can also be used by general practitioners and emergency physicians when diagnosing or treating eye disorders.

Primary Specialties:

Ophthalmology

70%

Optometry

20%

General Practice

10%

Clinical Scenarios:

• A patient presents with sudden vision loss and is diagnosed with a retinal detachment.
• A patient with a family history of retinitis pigmentosa is diagnosed with the disorder during a routine eye exam.
• A patient presents with eye pain and is diagnosed with choroiditis.
• A patient with a history of retinal vein occlusion presents with new symptoms.
• A patient presents with floaters and is diagnosed with a retinal break.

Resources & References

The official ICD-10 guidelines and the American Academy of Ophthalmology are excellent resources for coding disorders of the choroid and retina. Other resources include coding manuals and online coding forums.

Official Guidelines:

ICD-10-CM Official Guidelines for Coding and Reporting
American Academy of Ophthalmology

Clinical References:

Clinical notes
Imaging results

Educational Materials:

ICD-10 coding manuals
Online coding forums

Frequently Asked Questions

When should I use a seventh character?

A seventh character should be used for certain codes to indicate the stage of the disorder. Always check the Tabular List to see if a seventh character is required.