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ICD-10 Guide
ICD-10 CodesH16.121

H16.121

Billable

Filamentary keratitis, right eye

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

Code Description

ICD-10 H16.121 is a billable code used to indicate a diagnosis of filamentary keratitis, right eye.

Key Diagnostic Point:

Filamentary keratitis is characterized by the presence of fine, thread-like filaments on the corneal surface, primarily affecting the right eye in this instance. This condition often arises from various underlying causes, including dry eye syndrome, exposure keratopathy, or corneal epithelial defects. Clinically, patients may present with symptoms such as ocular discomfort, foreign body sensation, redness, and visual disturbances. The anatomy involved includes the cornea, which is the transparent front part of the eye, and the conjunctiva, which covers the white part of the eye. Disease progression can lead to corneal scarring or further epithelial damage if left untreated. Diagnostic considerations include a thorough patient history, slit-lamp examination, and possibly corneal staining with fluorescein to visualize the filaments. Treatment typically involves addressing the underlying cause, which may include artificial tears, topical medications, or in some cases, surgical intervention to restore corneal integrity.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful evaluation of symptoms and underlying causes.
  • Treatment complexity: May involve multiple treatment modalities depending on etiology.
  • Documentation requirements: Detailed clinical notes needed to support diagnosis and treatment.
  • Coding specificity: Requires precise coding to differentiate from other keratitis types.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected eye or condition.
  • Documentation gaps: Incomplete patient history or treatment rationale.
  • Billing challenges: Potential for denials if documentation does not clearly 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

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ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Filamentary keratitis can significantly impact patient quality of life due to discomfort and visual disturbances. It is essential for healthcare providers to recognize and manage this condition effectively to prevent complications such as corneal scarring. Understanding the epidemiology of filamentary keratitis, particularly in populations with high rates of dry eye syndrome, can inform public health strategies and improve patient outcomes. Quality measures may include tracking treatment effectiveness and patient-reported outcomes.

ICD-9 vs ICD-10

Filamentary keratitis can significantly impact patient quality of life due to discomfort and visual disturbances. It is essential for healthcare providers to recognize and manage this condition effectively to prevent complications such as corneal scarring. Understanding the epidemiology of filamentary keratitis, particularly in populations with high rates of dry eye syndrome, can inform public health strategies and improve patient outcomes. Quality measures may include tracking treatment effectiveness and patient-reported outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for ophthalmic services and ensuring that all relevant codes are included in the claim. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include thorough clinical notes, clear treatment plans, and regular audits of coding accuracy to minimize billing challenges.

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 H16.121?

H16.121 specifically covers filamentary keratitis affecting the right eye, which may be associated with conditions like dry eye syndrome, exposure keratopathy, or other corneal surface disorders.

When should H16.121 be used instead of related codes?

H16.121 should be used when the filamentary keratitis is specifically affecting the right eye, as opposed to unspecified or bilateral conditions, which would require different codes.

What documentation supports H16.121?

Documentation should include a detailed clinical examination, patient symptoms, treatment plans, and any diagnostic tests performed, such as corneal staining results.