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ICD-10 Guide
ICD-10 CodesH11.142

H11.142

Billable

Conjunctival xerosis, unspecified, left eye

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

Code Description

ICD-10 H11.142 is a billable code used to indicate a diagnosis of conjunctival xerosis, unspecified, left eye.

Key Diagnostic Point:

Conjunctival xerosis, unspecified, left eye, refers to the dryness of the conjunctiva, which is the thin, transparent membrane covering the white part of the eyeball and the inner surface of 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, a gritty sensation, and discomfort in the affected eye. The anatomy involved primarily includes the conjunctiva, but it may also affect the sclera and cornea due to associated dryness. Disease progression can lead to more severe ocular surface disorders if left untreated, potentially resulting in corneal damage or infection. Diagnostic considerations include a thorough patient history, examination of tear production, and assessment of ocular surface integrity. The use of fluorescein staining may help identify areas of dryness or damage on the cornea. Proper diagnosis is crucial to differentiate conjunctival xerosis from other ocular surface disorders, such as keratoconjunctivitis sicca (dry eye syndrome).

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful assessment to differentiate from other conditions.
  • Treatment complexity: May involve multiple treatment modalities including artificial tears, lifestyle modifications, or addressing underlying systemic issues.
  • Documentation requirements: Detailed documentation of symptoms, examination findings, and treatment plans is essential.
  • Coding specificity: Requires precise coding to indicate the affected eye and specific condition.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected eye or failure to specify the condition.
  • Documentation gaps: Incomplete records of symptoms or treatment plans may lead to denials.
  • Billing challenges: Potential for 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

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CPT Code

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CPT Code

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CPT Code

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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 visual disturbances. It is essential to recognize this condition as it may indicate underlying systemic issues, particularly in older adults or those with autoimmune diseases. Understanding the epidemiology of conjunctival xerosis can help healthcare providers identify at-risk populations and implement preventive measures, ultimately improving patient outcomes and reducing healthcare utilization.

ICD-9 vs ICD-10

Conjunctival xerosis can significantly impact a patient's quality of life, leading to discomfort and visual disturbances. It is essential to recognize this condition as it may indicate underlying systemic issues, particularly in older adults or those with autoimmune diseases. Understanding the epidemiology of conjunctival xerosis can help healthcare providers identify at-risk populations and implement preventive measures, ultimately improving patient outcomes and reducing healthcare utilization.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, so it is important to verify coverage policies. Common denials can occur if there is insufficient documentation to support the diagnosis or if the treatment plan is not clearly outlined. Best practices include using precise coding, maintaining thorough documentation, and ensuring that all services provided are justified based on the patient's condition.

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 H11.142?

H11.142 covers conjunctival xerosis, which may arise from environmental factors, systemic diseases like Sjögren's syndrome, or as a side effect of medications. It is characterized by dryness and irritation of the conjunctiva without specific underlying causes being identified.

When should H11.142 be used instead of related codes?

H11.142 should be used when the diagnosis of conjunctival xerosis is confirmed for the left eye without specific underlying causes. If there are additional details or specific conditions identified, other codes may be more appropriate.

What documentation supports H11.142?

Documentation should include a comprehensive patient history, clinical examination findings, symptom descriptions, and any diagnostic tests performed, such as tear break-up time or fluorescein staining results.