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ICD-10 Guide
ICD-10 CodesH11.24

H11.24

Non-billable

Scarring of conjunctiva

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

Code Description

ICD-10 H11.24 is a used to indicate a diagnosis of scarring of conjunctiva.

Key Diagnostic Point:

Scarring of the conjunctiva, classified under H11.24, refers to the pathological alteration of the conjunctival tissue characterized by fibrous tissue formation, which can result from various underlying conditions such as chronic inflammation, trauma, or surgical interventions. The conjunctiva is a thin, transparent membrane that covers the white part of the eyeball and lines the eyelids, playing a crucial role in protecting the eye and maintaining ocular surface health. Scarring can lead to symptoms such as discomfort, redness, and visual disturbances due to its impact on tear film stability and ocular surface integrity. Disease progression may vary, with some patients experiencing mild symptoms while others may develop significant complications, including dry eye syndrome or corneal damage. Diagnostic considerations include a thorough clinical examination, patient history, and potentially imaging studies to assess the extent of scarring and its effects on adjacent structures like the sclera and cornea. Treatment options may include lubricating eye drops, corticosteroids, or surgical intervention to restore conjunctival integrity and function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive assessment of ocular health and history.
  • Treatment complexity: May involve multiple treatment modalities depending on severity.
  • Documentation requirements: Detailed clinical notes necessary to support diagnosis.
  • Coding specificity: Requires precise coding to differentiate from other conjunctival disorders.

Audit Risk Factors

  • Common coding errors: Misapplication of codes related to conjunctival disorders.
  • Documentation gaps: Incomplete patient history or treatment notes.
  • Billing challenges: Potential denials due to lack of supporting documentation.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Scarring of the conjunctiva can significantly impact a patient's quality of life, leading to discomfort and visual impairment. Understanding the epidemiology of conjunctival scarring is essential for population health, as it can arise from preventable causes such as chemical exposure or inadequate treatment of conjunctivitis. Quality measures may include monitoring the incidence of conjunctival scarring in populations at risk and ensuring appropriate management strategies are in place to reduce its prevalence.

ICD-9 vs ICD-10

Scarring of the conjunctiva can significantly impact a patient's quality of life, leading to discomfort and visual impairment. Understanding the epidemiology of conjunctival scarring is essential for population health, as it can arise from preventable causes such as chemical exposure or inadequate treatment of conjunctivitis. Quality measures may include monitoring the incidence of conjunctival scarring in populations at risk and ensuring appropriate management strategies are in place to reduce its prevalence.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for ophthalmological services and ensuring that the diagnosis is supported by clinical evidence. Common denials may arise from insufficient documentation or incorrect coding, so it is essential to follow coding best practices, including using the most specific codes available and providing detailed notes on the patient's history and treatment response.

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 H11.24?

H11.24 encompasses conditions leading to conjunctival scarring, including chemical burns, chronic conjunctivitis, and post-surgical changes. It is essential to document the underlying cause to support the diagnosis.

When should H11.24 be used instead of related codes?

H11.24 should be used when there is clear evidence of conjunctival scarring, as opposed to other conditions like conjunctival hyperemia or inflammation, which may require different codes.

What documentation supports H11.24?

Documentation should include a detailed clinical examination, patient history regarding previous ocular conditions or surgeries, and any imaging studies that demonstrate the extent of scarring.