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ICD-10 Guide
ICD-10 CodesH11.149

H11.149

Billable

Conjunctival xerosis, unspecified, unspecified eye

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

Code Description

ICD-10 H11.149 is a billable code used to indicate a diagnosis of conjunctival xerosis, unspecified, unspecified eye.

Key Diagnostic Point:

Conjunctival xerosis, unspecified, is characterized by dryness of the conjunctiva, which can lead to discomfort, irritation, and potential visual disturbances. The conjunctiva is a thin, transparent membrane that covers the white part of the eyeball and lines the eyelids. In cases of conjunctival xerosis, the normal moisture balance is disrupted, often due to environmental factors, systemic diseases, or medication side effects. Symptoms may include a gritty sensation, redness, and increased sensitivity to light. The condition can progress 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 symptoms, and possibly the use of diagnostic tests such as tear break-up time or ocular surface staining. Treatment typically involves artificial tears, environmental modifications, and addressing any underlying causes. Regular monitoring is essential to prevent complications and manage symptoms effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires differentiation from other ocular surface disorders.
  • Treatment complexity: Moderate, involving both symptomatic relief and management of underlying causes.
  • Documentation requirements: Moderate, necessitating detailed patient history and symptom assessment.
  • Coding specificity: Medium, as it is important to specify the eye affected and the nature of the xerosis.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected eye or misclassification of the condition.
  • Documentation gaps: Incomplete patient history or lack of symptom detail.
  • Billing challenges: Potential denials due to insufficient documentation supporting the diagnosis.

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 affect patient quality of life, leading to discomfort and potential complications if untreated. It is prevalent in populations exposed to dry environments or those with systemic conditions affecting tear production. Understanding the epidemiology of this condition can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to eye health may include monitoring the incidence of conjunctival xerosis and ensuring appropriate management to reduce complications and improve patient outcomes.

ICD-9 vs ICD-10

Conjunctival xerosis can significantly affect patient quality of life, leading to discomfort and potential complications if untreated. It is prevalent in populations exposed to dry environments or those with systemic conditions affecting tear production. Understanding the epidemiology of this condition can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to eye health may include monitoring the incidence of conjunctival xerosis and ensuring appropriate management to reduce complications and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, so understanding the specific requirements of each insurance provider is crucial for successful claims processing.

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 H11.149?

H11.149 covers cases of conjunctival xerosis that are unspecified, meaning the exact cause or associated conditions (such as Sjögren's syndrome or environmental factors) are not detailed. It is important to document any related symptoms or findings to support the diagnosis.

When should H11.149 be used instead of related codes?

H11.149 should be used when the conjunctival xerosis is not localized to a specific eye or when the underlying cause is not identified. If the condition is specific to one eye or associated with a known condition, the corresponding specific code should be utilized.

What documentation supports H11.149?

Documentation should include a comprehensive patient history, a detailed account of symptoms, any relevant environmental factors, and results from diagnostic tests that confirm the diagnosis of conjunctival xerosis.