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ICD-10 Guide
ICD-10 CodesH11.8

H11.8

Non-billable

Other specified disorders of conjunctiva

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

Code Description

ICD-10 H11.8 is a used to indicate a diagnosis of other specified disorders of conjunctiva.

Key Diagnostic Point:

H11.8 refers to other specified disorders of the conjunctiva, which encompasses a range of conditions affecting the conjunctival tissue, the thin membrane covering the white part of the eyeball and the inner eyelids. Clinically, these disorders can present with symptoms such as redness, irritation, discharge, and discomfort. The conjunctiva, along with the sclera and cornea, plays a crucial role in eye health, providing protection and lubrication. Disorders may include conjunctival cysts, conjunctival papillomas, and other atypical growths or inflammatory conditions. Disease progression can vary; some conditions may be benign and self-limiting, while others may require intervention to prevent complications such as vision impairment or secondary infections. Diagnostic considerations include thorough ocular examination, patient history, and possibly imaging or biopsy to determine the nature of the conjunctival disorder. Accurate diagnosis is essential for appropriate management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other ocular conditions.
  • Treatment complexity: May involve topical medications, surgical interventions, or referral to specialists.
  • Documentation requirements: Detailed clinical notes and diagnostic evidence are necessary.
  • Coding specificity: Requires precise coding to capture the specific conjunctival disorder.

Audit Risk Factors

  • Common coding errors: Misidentification of the specific conjunctival disorder.
  • Documentation gaps: Incomplete clinical notes that do not support the diagnosis.
  • Billing challenges: Potential denials due to lack of specificity in coding.

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

The clinical significance of H11.8 lies in its potential to affect patient quality of life and visual health. Disorders of the conjunctiva can lead to discomfort and, if untreated, may result in complications such as secondary infections or vision impairment. Understanding the epidemiology of these conditions can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to timely diagnosis and treatment of conjunctival disorders can enhance healthcare utilization patterns and improve overall patient outcomes.

ICD-9 vs ICD-10

The clinical significance of H11.8 lies in its potential to affect patient quality of life and visual health. Disorders of the conjunctiva can lead to discomfort and, if untreated, may result in complications such as secondary infections or vision impairment. Understanding the epidemiology of these conditions can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to timely diagnosis and treatment of conjunctival disorders can enhance healthcare utilization patterns and improve overall patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the condition and the treatment provided. Common denials can occur if the documentation does not clearly justify the use of H11.8, particularly if the condition is not well-defined. Best practices include using precise coding, maintaining detailed clinical notes, and ensuring that all services rendered are appropriately linked to the diagnosis.

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 H11.8?

H11.8 includes various conjunctival disorders such as conjunctival cysts, conjunctival papillomas, and other specified conditions that do not fall under more common categories. Each condition has distinct diagnostic criteria that must be met for accurate coding.

When should H11.8 be used instead of related codes?

H11.8 should be used when a specific conjunctival disorder is identified that does not fit into the more commonly defined categories of conjunctival disorders. It is important to ensure that the clinical documentation supports the diagnosis.

What documentation supports H11.8?

Documentation should include a comprehensive ocular examination, detailed patient history, and any diagnostic tests performed. Clinical notes must clearly outline the findings that led to the diagnosis of a specified conjunctival disorder.