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ICD-10 Guide
ICD-10 CodesH11.33

H11.33

Billable

Conjunctival hemorrhage, bilateral

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

Code Description

ICD-10 H11.33 is a billable code used to indicate a diagnosis of conjunctival hemorrhage, bilateral.

Key Diagnostic Point:

Conjunctival hemorrhage, bilateral, is characterized by the presence of blood in the conjunctival sac of both eyes, resulting from the rupture of small blood vessels. Clinically, patients may present with a sudden onset of redness in the eyes, which can be alarming but is often painless. The conjunctiva, a thin membrane covering the sclera and lining the eyelids, is the primary anatomical structure involved. Causes of bilateral conjunctival hemorrhage can include trauma, increased venous pressure from conditions such as hypertension, or systemic disorders like coagulopathy. Disease progression is typically benign, with most cases resolving spontaneously within one to two weeks. Diagnostic considerations include a thorough history and physical examination to rule out underlying systemic conditions or ocular trauma. Additional tests may be warranted in cases where the hemorrhage is recurrent or associated with other ocular symptoms. Understanding the etiology is crucial for appropriate management and to prevent potential complications such as vision impairment or chronic irritation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires differentiation from other causes of eye redness.
  • Treatment complexity: Low, as most cases resolve without intervention.
  • Documentation requirements: Moderate, necessitating detailed patient history and examination findings.
  • Coding specificity: Medium, as it is specific to bilateral conjunctival hemorrhage but may require differentiation from unilateral cases.

Audit Risk Factors

  • Common coding errors: Misclassification of unilateral vs bilateral cases.
  • Documentation gaps: Incomplete patient history or lack of follow-up notes.
  • 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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Bilateral conjunctival hemorrhage is generally a benign condition; however, its clinical significance lies in its potential association with systemic diseases. Understanding its epidemiology is crucial, as it may indicate underlying health issues, particularly in older populations. Quality measures may include monitoring the incidence of conjunctival hemorrhage in patients with hypertension or bleeding disorders, influencing healthcare utilization patterns and guiding preventive care strategies.

ICD-9 vs ICD-10

Bilateral conjunctival hemorrhage is generally a benign condition; however, its clinical significance lies in its potential association with systemic diseases. Understanding its epidemiology is crucial, as it may indicate underlying health issues, particularly in older populations. Quality measures may include monitoring the incidence of conjunctival hemorrhage in patients with hypertension or bleeding disorders, influencing healthcare utilization patterns and guiding preventive care strategies.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the medical necessity for the visit and any associated diagnostic tests. Common denials may arise from insufficient documentation or failure to demonstrate the clinical significance of the condition. Best practices include maintaining thorough records of patient encounters, including history, examination findings, and treatment plans, to support the coding and billing process effectively.

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 H11.33?

H11.33 specifically covers bilateral conjunctival hemorrhage, which may arise from trauma, systemic hypertension, or coagulopathy. It does not cover hemorrhages due to other ocular conditions or unilateral cases.

When should H11.33 be used instead of related codes?

H11.33 should be used when both eyes exhibit conjunctival hemorrhage. If only one eye is affected, H11.32 should be selected. Accurate documentation of the clinical findings is essential for appropriate code selection.

What documentation supports H11.33?

Documentation should include a detailed patient history, physical examination findings indicating bilateral conjunctival hemorrhage, and any relevant diagnostic tests performed to rule out other conditions.