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ICD-10 Guide
ICD-10 CodesB30.1

B30.1

Viral Conjunctivitis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 B30.1 is a billable code used to indicate a diagnosis of viral conjunctivitis.

Key Diagnostic Point:

Viral conjunctivitis, commonly referred to as pink eye, is an inflammation of the conjunctiva caused by viral infections. The most prevalent viruses responsible for this condition include adenoviruses, which are known for causing outbreaks, especially in communal settings such as schools and daycare centers. Other viral agents include herpes simplex virus (HSV) and varicella-zoster virus (VZV). Symptoms typically include redness, itching, tearing, and discharge from the eye, which may be watery or mucous-like. Diagnosis is primarily clinical, based on the patient's history and physical examination, although laboratory tests such as conjunctival swabs may be utilized to identify specific viral pathogens in atypical cases. Treatment is generally supportive, focusing on symptom relief, as most viral conjunctivitis cases resolve spontaneously within 1-2 weeks. Antiviral medications may be indicated in cases caused by HSV, particularly if keratitis is present. Proper hygiene practices are crucial to prevent the spread of the infection, especially in outbreak situations.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Commonly diagnosed condition with clear symptoms
  • Standardized diagnostic criteria
  • Limited need for extensive laboratory testing
  • Well-defined treatment protocols

Audit Risk Factors

  • Inconsistent documentation of symptoms
  • Failure to specify the viral agent when known
  • Misclassification with bacterial conjunctivitis (H10.1)
  • Inadequate follow-up documentation

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Detailed examination findings, including visual acuity and specific symptoms.

Common Clinical Scenarios

Patients presenting with acute redness, tearing, and discharge.

Billing Considerations

Ensure to document any associated conditions, such as keratitis, for accurate coding.

Primary Care

Documentation Requirements

History of present illness, symptom duration, and any treatments attempted.

Common Clinical Scenarios

Patients with conjunctivitis symptoms, especially in outbreak settings.

Billing Considerations

Document patient education on hygiene and prevention measures.

Coding Guidelines

Inclusion Criteria

Use B30.1 When
  • According to the ICD
  • CM coding guidelines, B30
  • 1 should be used when the diagnosis of viral conjunctivitis is confirmed
  • It is important to document the specific viral agent when known, as this may affect treatment and management

Exclusion Criteria

Do NOT use B30.1 When
  • Exclude cases where the conjunctivitis is due to bacterial or allergic causes

Related CPT Codes

92002CPT Code

Ophthalmological examination, new patient

Clinical Scenario

Used when a new patient presents with symptoms of conjunctivitis.

Documentation Requirements

Document the examination findings and any treatments provided.

Specialty Considerations

Ophthalmologists should ensure comprehensive documentation of visual acuity and conjunctival examination.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of viral conjunctivitis, improving the accuracy of data collection and reimbursement processes. The detailed classification helps in tracking outbreaks and understanding epidemiological trends.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of viral conjunctivitis, improving the accuracy of data collection and reimbursement processes. The detailed classification helps in tracking outbreaks and understanding epidemiological trends.

Reimbursement & Billing Impact

reimbursement processes. The detailed classification helps in tracking outbreaks and understanding epidemiological trends.

Resources

Clinical References

  • •
    CDC Viral Conjunctivitis Information

Coding & Billing References

  • •
    CDC Viral Conjunctivitis Information

Frequently Asked Questions

What are the common symptoms of viral conjunctivitis?

Common symptoms include redness of the eye, itching, tearing, and a watery or mucous discharge. Patients may also experience a gritty sensation in the eye.

How is viral conjunctivitis diagnosed?

Diagnosis is primarily clinical, based on the patient's symptoms and history. In some cases, laboratory tests may be performed to identify the specific viral agent.

What treatments are available for viral conjunctivitis?

Treatment is generally supportive, focusing on symptom relief. Antiviral medications may be prescribed in cases caused by herpes simplex virus.

How can viral conjunctivitis be prevented?

Preventive measures include practicing good hygiene, such as frequent handwashing, avoiding touching the eyes, and not sharing personal items like towels or eye makeup.