Diseases of the eye and adnexa
This chapter covers ICD-10-CM codes in the range H00-H59 for diseases of the eye and adnexa. Covers disorders of the eye and surrounding structures including glaucoma, cataracts, and visual disturbances.
Chapter Overview
Key Statistics
- •Contains 12 categories and 39 total codes
- •Includes 4 billable codes and 35 non-billable codes
- •Chapter range: H00-H59
Clinical Relevance
Used for ophthalmologic conditions including cataracts, glaucoma, and retinal disorders. Essential for ophthalmology practices and vision-related care.
Documentation Requirements
Requires laterality (right, left, bilateral), visual acuity measurements, and stage of disease progression for chronic conditions.
Special Considerations
External cause codes required for traumatic eye injuries. Diabetic and hypertensive eye disease requires underlying condition codes.
Categories in this Chapter
Disorders of eyelid, lacrimal system and orbit
Disorders of conjunctiva
Disorders of sclera, cornea, iris and ciliary body
Disorders of lens
Disorders of choroid and retina
Glaucoma
Disorders of vitreous body and globe
Disorders of optic nerve and visual pathways
Disorders of ocular muscles, binocular movement, accommodation and refraction
Visual disturbances and blindness
Other disorders of eye and adnexa
Intraoperative and postprocedural complications and disorders of eye and adnexa
Chapter-Specific Coding Guidelines
General Guidelines for Diseases of the eye and adnexa:
- Follow standard ICD-10-CM coding principles for diseases of the eye and adnexa
- Document the most specific diagnosis supported by the medical record
- Use additional codes for manifestations, complications, or associated conditions
- Ensure proper sequencing based on the reason for the encounter
Documentation Requirements:
- •Specific condition or disease process
- •Acute versus chronic status when applicable
- •Severity or stage when documented
- •Associated symptoms or complications
- •Treatment response and current status
Sequencing Rules:
- Principal diagnosis should reflect the main reason for the encounter
- Sequence complications according to treatment focus
- Use appropriate combination codes when available
- Follow chapter-specific sequencing guidelines
When to Use:
- ✓For conditions classified in the H00-H59 range
- ✓When the condition is the primary focus of care
- ✓During active treatment or monitoring
- ✓For documented complications of the condition
When NOT to Use:
- ✗For personal history without current manifestations
- ✗During screening encounters without findings
- ✗For conditions better classified elsewhere
- ✗When condition is ruled out or suspected only
Special Considerations:
- ⚠Review chapter-specific coding guidelines
- ⚠Consider combination codes before multiple codes
- ⚠Document functional impact when relevant
- ⚠Use external cause codes when applicable
Version Updates
The 2025 ICD-10-CM updates include refinements to diseases of the eye and adnexa coding for improved specificity and clinical relevance.
Recent Updates:
Enhanced Diseases of the eye and adnexa Specificity
Updated codes within H00-H59 for improved clinical documentation
Impact: Better alignment with clinical practice and quality reporting
Implementation Guidance:
- •Review all diseases of the eye and adnexa coding practices
- •Update documentation templates as needed
- •Train coding staff on any new requirements
- •Implement quality checks for accuracy
Upcoming Changes:
- →Potential enhancements to diseases of the eye and adnexa codes in future updates
- →Continued alignment with clinical practice evolution
Related Resources
Key resources for diseases of the eye and adnexa coding and clinical documentation.
Official Documentation:
Related Chapters:
Tools and References:
Frequently Asked Questions
What are the key considerations when coding diseases of the eye and adnexa?
Focus on specific diagnosis documentation, proper sequencing, and use of additional codes for complications or manifestations related to diseases of the eye and adnexa.
How do I determine the most appropriate code within this chapter?
Review the medical documentation for the most specific diagnosis, check for combination codes, and follow the ICD-10-CM guidelines for this chapter.
When should I use additional codes?
Use additional codes for manifestations, complications, external causes, or other conditions that affect patient care during the encounter.