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ICD-10 Guide
ICD-10 CodesH16.12

H16.12

Non-billable

Filamentary keratitis

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

Code Description

ICD-10 H16.12 is a used to indicate a diagnosis of filamentary keratitis.

Key Diagnostic Point:

Filamentary keratitis is characterized by the presence of fine, thread-like filaments on the corneal surface, often leading to irritation, discomfort, and potential vision impairment. This condition primarily affects the cornea, which is the transparent front part of the eye, and can also involve the conjunctiva and sclera. The filaments are typically composed of degenerated epithelial cells and mucus, which can adhere to the corneal surface and cause epithelial damage. Clinically, patients may present with symptoms such as foreign body sensation, redness, tearing, and photophobia. The disease progression can vary; if left untreated, filamentary keratitis may lead to corneal scarring or ulceration. Diagnostic considerations include a thorough ocular examination, often utilizing fluorescein staining to visualize the filaments. Differential diagnoses may include other forms of keratitis, such as viral or bacterial keratitis, making accurate diagnosis essential for effective management. Treatment typically involves lubricating eye drops, topical medications, and in some cases, debridement of the filaments to alleviate symptoms and promote healing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other keratitis types.
  • Treatment complexity: May involve multiple therapeutic approaches.
  • Documentation requirements: Detailed clinical notes necessary for accurate coding.
  • Coding specificity: Specific to filamentary keratitis, necessitating precise coding.

Audit Risk Factors

  • Common coding errors: Misidentifying filamentary keratitis as other keratitis types.
  • Documentation gaps: Incomplete clinical notes may lead to coding inaccuracies.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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

Filamentary keratitis can significantly affect patient quality of life due to discomfort and potential vision impairment. Understanding its epidemiology is crucial, as it may be more prevalent in populations with dry eye syndrome or those exposed to environmental irritants. Effective management can improve patient outcomes and reduce healthcare utilization by preventing complications such as corneal scarring or ulceration.

ICD-9 vs ICD-10

Filamentary keratitis can significantly affect patient quality of life due to discomfort and potential vision impairment. Understanding its epidemiology is crucial, as it may be more prevalent in populations with dry eye syndrome or those exposed to environmental irritants. Effective management can improve patient outcomes and reduce healthcare utilization by preventing complications such as corneal scarring or ulceration.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by clinical findings and that any procedures performed are appropriately coded. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining thorough clinical notes, using appropriate CPT codes for any procedures, and ensuring that all billing aligns with the diagnosis documented in the patient’s record.

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 H16.12?

H16.12 specifically covers filamentary keratitis, which is characterized by the presence of filamentary strands on the cornea, often resulting from dry eye conditions, exposure keratopathy, or other ocular surface disorders.

When should H16.12 be used instead of related codes?

H16.12 should be used when the clinical presentation specifically indicates filamentary keratitis, particularly when filament formation is observed during examination, differentiating it from other keratitis types.

What documentation supports H16.12?

Documentation should include a detailed ocular examination report, noting the presence of filaments, patient symptoms, and any treatments attempted. Clinical notes must clearly indicate the diagnosis of filamentary keratitis.