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ICD-10 Guide
ICD-10 CodesH11.21

H11.21

Non-billable

Conjunctival adhesions and strands (localized)

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

Code Description

ICD-10 H11.21 is a used to indicate a diagnosis of conjunctival adhesions and strands (localized).

Key Diagnostic Point:

Conjunctival adhesions and strands (localized) refer to abnormal fibrous connections that form between the conjunctiva and adjacent structures, such as the sclera or cornea. These adhesions can arise due to various conditions, including chronic inflammation, trauma, or surgical interventions. Clinically, patients may present with symptoms such as discomfort, visual disturbances, or restricted eye movement. The conjunctiva, a thin membrane covering the white part of the eye and the inner eyelids, plays a crucial role in maintaining ocular surface health. The presence of adhesions can lead to complications like corneal exposure or scarring, potentially affecting vision. Disease progression may vary; in some cases, adhesions can resolve spontaneously, while in others, they may necessitate surgical intervention. Diagnostic considerations include a thorough ocular examination, slit-lamp biomicroscopy, and possibly imaging studies to assess the extent of the adhesions and their impact on surrounding structures. Accurate diagnosis is essential for determining the appropriate management strategy, which may involve medical therapy or surgical correction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires specialized ocular examination and possibly imaging.
  • Treatment complexity: May involve both medical management and surgical intervention.
  • Documentation requirements: Detailed clinical notes and imaging reports are necessary.
  • Coding specificity: Requires precise coding to differentiate from other conjunctival conditions.

Audit Risk Factors

  • Common coding errors: Misclassification with other conjunctival disorders.
  • Documentation gaps: Incomplete records regarding the extent and impact of adhesions.
  • 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

Optometry

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Conjunctival adhesions can significantly impact patient quality of life, leading to discomfort and potential vision impairment. Understanding the epidemiology of this condition is crucial, as it may be more prevalent in populations with a history of ocular surgery or chronic inflammatory conditions. Effective management of conjunctival adhesions can improve patient outcomes and reduce healthcare utilization by preventing complications that require more extensive interventions.

ICD-9 vs ICD-10

Conjunctival adhesions can significantly impact patient quality of life, leading to discomfort and potential vision impairment. Understanding the epidemiology of this condition is crucial, as it may be more prevalent in populations with a history of ocular surgery or chronic inflammatory conditions. Effective management of conjunctival adhesions can improve patient outcomes and reduce healthcare utilization by preventing complications that require more extensive interventions.

Reimbursement & Billing Impact

reimbursement.

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 H11.21?

H11.21 specifically covers localized conjunctival adhesions and strands, which may occur due to conditions such as conjunctivitis, surgical scarring, or trauma. It does not include generalized adhesions or those associated with systemic diseases.

When should H11.21 be used instead of related codes?

H11.21 should be used when there is clear documentation of localized conjunctival adhesions. If the adhesions are generalized or unspecified, H11.20 may be more appropriate. Accurate differentiation is crucial for proper coding.

What documentation supports H11.21?

Documentation should include a detailed ocular examination report, findings from slit-lamp examination, and any imaging studies that demonstrate the presence and extent of the adhesions. Clinical notes should also outline the patient's symptoms and treatment plan.