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ICD-10 Guide
ICD-10 CodesH11.14

H11.14

Non-billable

Conjunctival xerosis, unspecified

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

Code Description

ICD-10 H11.14 is a used to indicate a diagnosis of conjunctival xerosis, unspecified.

Key Diagnostic Point:

Conjunctival xerosis, or dryness of the conjunctiva, is a condition characterized by insufficient moisture in the conjunctival tissue, leading to irritation and discomfort. The conjunctiva is a thin membrane that covers the white part of the eyeball and lines the inside of the eyelids. This condition can result from various factors, including environmental conditions, systemic diseases, or medications that reduce tear production. Clinically, patients may present with symptoms such as redness, a gritty sensation, burning, and excessive tearing as a compensatory mechanism. Disease progression can lead to more severe ocular surface disorders if left untreated, potentially affecting the cornea and leading to complications such as corneal ulcers or scarring. Diagnostic considerations include a thorough patient history, assessment of tear production using tests like the Schirmer test, and examination of the ocular surface with fluorescein staining. It is crucial to differentiate conjunctival xerosis from other ocular surface disorders, such as dry eye syndrome or conjunctivitis, to ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other ocular conditions.
  • Treatment complexity: Management may involve artificial tears, environmental modifications, or addressing underlying systemic issues.
  • Documentation requirements: Detailed clinical notes on symptoms, examination findings, and treatment plans are necessary.
  • Coding specificity: Accurate coding requires understanding of the specific nature and cause of conjunctival xerosis.

Audit Risk Factors

  • Common coding errors: Misclassification with other conjunctival disorders.
  • Documentation gaps: Incomplete patient history or lack of symptom description.
  • Billing challenges: Potential denials if the medical necessity is not clearly documented.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Conjunctival xerosis can significantly impact patient quality of life, leading to discomfort and visual disturbances. It is essential for healthcare providers to recognize and manage this condition effectively to prevent complications. The prevalence of dry eye symptoms in the population highlights the importance of awareness and appropriate treatment strategies. Addressing conjunctival xerosis can improve patient satisfaction and reduce healthcare utilization associated with advanced ocular surface diseases.

ICD-9 vs ICD-10

Conjunctival xerosis can significantly impact patient quality of life, leading to discomfort and visual disturbances. It is essential for healthcare providers to recognize and manage this condition effectively to prevent complications. The prevalence of dry eye symptoms in the population highlights the importance of awareness and appropriate treatment strategies. Addressing conjunctival xerosis can improve patient satisfaction and reduce healthcare utilization associated with advanced ocular surface diseases.

Reimbursement & Billing Impact

reimbursement considerations include the need for prior authorization for certain treatments and the importance of using the correct CPT codes that correspond to the level of service provided. It is also essential to stay updated on payer-specific guidelines, as they may have unique requirements for documentation and coding related to conjunctival xerosis.

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 H11.14?

H11.14 specifically covers conjunctival xerosis that is not attributed to a known systemic disease or environmental factor. It may include idiopathic cases or those related to medication side effects.

When should H11.14 be used instead of related codes?

H11.14 should be used when the conjunctival xerosis is not linked to a specific underlying condition or when the cause is unknown. If a systemic disease is identified, H11.13 would be more appropriate.

What documentation supports H11.14?

Documentation should include a detailed patient history, symptom description, results from ocular surface examinations, and any treatments attempted. This information is essential to substantiate the diagnosis and support the medical necessity of the services provided.