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ICD-10 Guide
ICD-10 CodesH16.119

H16.119

Billable

Macular keratitis, unspecified eye

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

Code Description

ICD-10 H16.119 is a billable code used to indicate a diagnosis of macular keratitis, unspecified eye.

Key Diagnostic Point:

Macular keratitis, unspecified eye

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity
Macular keratitis can vary in severity, ranging from mild irritation to significant visual impairment. Diagnosis may require comprehensive eye examinations and potentially imaging studies, leading to moderate clinical complexity.

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

Coding Guidelines

Inclusion Criteria

Use H16.119 When
  • Ensure accurate documentation of symptoms, duration, and any prior treatments
  • Use H16
  • 119 when the specific eye affected is not documented
  • If the condition is bilateral, use additional codes to specify both eyes

Exclusion Criteria

Do NOT use H16.119 When
No specific exclusions found.

Related ICD-10 Codes

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CPT Code

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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

Accurate coding of H16.119 is essential for appropriate reimbursement and to reflect the severity of the condition in clinical records. Misclassification may lead to claim denials or delays.

ICD-9 vs ICD-10

Accurate coding of H16.119 is essential for appropriate reimbursement and to reflect the severity of the condition in clinical records. Misclassification may lead to claim denials or delays.

Reimbursement & Billing Impact

reimbursement and to reflect the severity of the condition in clinical records. Misclassification may lead to claim denials or delays.

Resources

Clinical References

  • •
    American Academy of Ophthalmology - Macular Keratitis
  • •
    National Eye Institute - Corneal Diseases

Coding & Billing References

  • •
    American Academy of Ophthalmology - Macular Keratitis
  • •
    National Eye Institute - Corneal Diseases

Frequently Asked Questions

What are the common symptoms of macular keratitis?

Common symptoms include blurred vision, eye pain, redness, and sensitivity to light.

How is macular keratitis treated?

Treatment may involve topical antibiotics, anti-inflammatory medications, or in some cases, surgical intervention depending on the severity.

Can macular keratitis affect both eyes?

Yes, while it can occur in one eye, it is possible for macular keratitis to affect both eyes simultaneously.