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v1.0.0
ICD-10 Guide
ICD-10 CodesH16.243

H16.243

Billable

Ophthalmia nodosa, bilateral

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

Code Description

ICD-10 H16.243 is a billable code used to indicate a diagnosis of ophthalmia nodosa, bilateral.

Key Diagnostic Point:

Ophthalmia nodosa, bilateral

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity
Ophthalmia nodosa can present with varying degrees of ocular inflammation and may require multidisciplinary management, including medical and surgical interventions. The complexity is moderate due to potential complications and the need for thorough documentation.

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 H16.243 When
  • Ensure accurate documentation of the diagnosis, including the bilateral nature of the condition
  • Document any associated symptoms, treatments provided, and follow
  • up care
  • Use additional codes for any related conditions or complications

Exclusion Criteria

Do NOT use H16.243 When
No specific exclusions found.

Related ICD-10 Codes

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CPT Code

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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 H16.243 is crucial for appropriate reimbursement and to reflect the complexity of care provided. Misclassification can lead to claim denials and impact patient care continuity.

ICD-9 vs ICD-10

Accurate coding of H16.243 is crucial for appropriate reimbursement and to reflect the complexity of care provided. Misclassification can lead to claim denials and impact patient care continuity.

Reimbursement & Billing Impact

reimbursement and to reflect the complexity of care provided. Misclassification can lead to claim denials and impact patient care continuity.

Resources

Clinical References

  • •
    Ophthalmia Nodosa: Clinical Overview
  • •
    ICD-10-CM Coding Guidelines for Ophthalmology
  • •
    Understanding Eye Disorders: A Comprehensive Guide

Coding & Billing References

  • •
    Ophthalmia Nodosa: Clinical Overview
  • •
    ICD-10-CM Coding Guidelines for Ophthalmology
  • •
    Understanding Eye Disorders: A Comprehensive Guide

Frequently Asked Questions

What are the common symptoms of ophthalmia nodosa?

Common symptoms include redness, swelling, pain, and discharge from the eyes, along with potential vision changes.

How is ophthalmia nodosa treated?

Treatment may include topical or systemic corticosteroids, antibiotics, and in some cases, surgical intervention to address complications.

Is ophthalmia nodosa contagious?

No, ophthalmia nodosa is not contagious; it is typically caused by exposure to certain environmental factors or allergens.