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ICD-10 Guide
ICD-10 CodesH11.143

H11.143

Billable

Conjunctival xerosis, unspecified, bilateral

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 H11.143 is a billable code used to indicate a diagnosis of conjunctival xerosis, unspecified, bilateral.

Key Diagnostic Point:

Conjunctival xerosis, unspecified, bilateral, refers to a condition characterized by dryness of the conjunctiva, the thin membrane that covers the white part of the eyeball and lines the eyelids. This condition can result from various factors, including environmental conditions, systemic diseases, or medication side effects. Clinically, patients may present with symptoms such as irritation, redness, burning, and a sensation of grittiness in the eyes. The conjunctiva may appear pale or have a rough texture upon examination. The disease progression can vary; if left untreated, conjunctival xerosis can lead to more severe ocular surface disorders, including corneal damage. Diagnostic considerations include a thorough patient history, assessment of symptoms, and possibly the use of diagnostic tests such as tear break-up time or ocular surface staining. It is essential to differentiate conjunctival xerosis from other ocular surface disorders, such as keratoconjunctivitis sicca, to ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misidentifying the condition as keratoconjunctivitis sicca.
  • Documentation gaps may arise if the specific cause of xerosis is not clearly stated.
  • Billing challenges can occur if the treatment plan is not well-documented, leading to denials.

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Primary care

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Conjunctival xerosis can significantly impact a patient's quality of life, leading to discomfort and potential complications if untreated. It is essential to recognize its prevalence in populations at risk, such as the elderly or those with autoimmune conditions. Understanding the epidemiology of conjunctival xerosis can help healthcare providers implement preventive measures and improve patient outcomes through timely diagnosis and management.

ICD-9 vs ICD-10

Conjunctival xerosis can significantly impact a patient's quality of life, leading to discomfort and potential complications if untreated. It is essential to recognize its prevalence in populations at risk, such as the elderly or those with autoimmune conditions. Understanding the epidemiology of conjunctival xerosis can help healthcare providers implement preventive measures and improve patient outcomes through timely diagnosis and management.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis aligns with the services provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that the billing reflects the bilateral nature of the condition and any associated treatments, such as artificial tears or other therapeutic interventions.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by H11.143?

H11.143 covers bilateral conjunctival xerosis without specifying the underlying cause. It may be associated with environmental factors, systemic diseases like Sjögren's syndrome, or side effects from medications.

When should H11.143 be used instead of related codes?

H11.143 should be used when the condition is bilateral and unspecified. If the xerosis is unilateral or has a known cause, other specific codes should be selected.

What documentation supports H11.143?

Documentation should include a detailed patient history, symptom description, clinical findings during examination, and any diagnostic tests performed to support the diagnosis of bilateral conjunctival xerosis.