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v1.0.0
ICD-10 Guide
ICD-10 CodesQ11.0

Q11.0

Billable

Cystic eyeball

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q11.0 is a billable code used to indicate a diagnosis of cystic eyeball.

Key Diagnostic Point:

Cystic eyeball, classified under congenital malformations of the eye, refers to a condition where the eyeball is abnormally formed, resulting in a cystic structure instead of a normal ocular anatomy. This malformation can occur due to various genetic and environmental factors during fetal development. The cystic structure may contain fluid and can lead to complications such as vision impairment or other ocular anomalies. Cystic eyeball is often associated with other congenital conditions, including anophthalmia (absence of one or both eyes) and microphthalmia (abnormally small eyes). Diagnosis typically involves imaging studies and clinical examination to assess the extent of the malformation and any associated anomalies. Management may require a multidisciplinary approach, including pediatric ophthalmology and genetics, to address both the ocular and systemic implications of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and associated anomalies
  • Need for detailed clinical documentation
  • Potential for co-occurring congenital conditions
  • Differentiation from similar ocular malformations

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Misclassification with similar ocular conditions
  • Failure to document genetic counseling or testing
  • Inconsistent coding across different healthcare settings

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed descriptions of the ocular findings, associated systemic anomalies, and any interventions performed.

Common Clinical Scenarios

Common scenarios include newborns presenting with ocular abnormalities during routine examinations or referrals from pediatricians for suspected congenital eye conditions.

Billing Considerations

Coders should be aware of the developmental milestones and potential impacts on vision and overall development in affected children.

Genetics

Documentation Requirements

Genetic documentation should include family history, results of genetic testing, and any syndromic associations with the cystic eyeball.

Common Clinical Scenarios

Scenarios may involve genetic counseling sessions for families with a history of congenital eye malformations or syndromes associated with ocular anomalies.

Billing Considerations

Consideration of chromosomal abnormalities and syndromic presentations is crucial for accurate coding and management.

Coding Guidelines

Inclusion Criteria

Use Q11.0 When
  • According to ICD
  • 10 coding guidelines, congenital conditions should be coded based on the specific malformation and any associated anomalies
  • Documentation must clearly indicate the nature of the malformation and any interventions performed

Exclusion Criteria

Do NOT use Q11.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used for follow-up examinations of patients with cystic eyeball.

Documentation Requirements

Documentation must include visual acuity assessments and any findings related to the cystic structure.

Specialty Considerations

Pediatric ophthalmologists should ensure thorough documentation of developmental assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, including cystic eyeball, which aids in better tracking and management of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, including cystic eyeball, which aids in better tracking and management of these conditions.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common associated conditions with cystic eyeball?

Cystic eyeball may be associated with other congenital anomalies such as anophthalmia, microphthalmia, and various syndromic conditions. Genetic evaluation is often recommended to assess for these associations.