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v1.0.0
ICD-10 Guide
ICD-10 CodesQ13.2

Q13.2

Billable

Other congenital malformations of iris

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

Code Description

ICD-10 Q13.2 is a billable code used to indicate a diagnosis of other congenital malformations of iris.

Key Diagnostic Point:

Congenital malformations of the iris can manifest in various forms, including coloboma, aniridia, and other structural anomalies. These conditions may arise from disruptions during embryonic development, leading to incomplete formation of the iris. Coloboma, for instance, is characterized by a keyhole-shaped defect in the iris, which can affect vision depending on its severity and associated ocular anomalies. Aniridia, a more severe condition, involves the absence of the iris, often accompanied by other ocular defects such as cataracts or glaucoma. The impact of these malformations can vary significantly, with some children experiencing minimal visual impairment while others may face significant challenges. Early diagnosis and intervention are crucial for managing these conditions, which may also be associated with systemic syndromes or chromosomal abnormalities. Genetic counseling is often recommended for families, especially when there is a suspicion of hereditary syndromes linked to these malformations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of iris malformations
  • Potential association with systemic syndromes or chromosomal abnormalities
  • Need for detailed documentation of ocular and systemic findings
  • Differentiation from other congenital eye anomalies

Audit Risk Factors

  • Inadequate documentation of the specific type of iris malformation
  • Failure to note associated systemic conditions or syndromes
  • Misclassification of the malformation type
  • Lack of genetic counseling notes when applicable

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed descriptions of the iris malformation, associated ocular findings, and any systemic implications. Growth and developmental assessments are also important.

Common Clinical Scenarios

Common scenarios include routine pediatric eye examinations where iris malformations are detected, referrals for genetic counseling, and management of associated visual impairments.

Billing Considerations

Special considerations include the need for multidisciplinary care involving ophthalmology, genetics, and possibly other specialties depending on associated anomalies.

Genetics

Documentation Requirements

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

Common Clinical Scenarios

Genetic counseling sessions for families with a history of congenital eye anomalies, evaluation of syndromic conditions, and discussions regarding recurrence risks.

Billing Considerations

Considerations include the potential for chromosomal abnormalities and the need for comprehensive genetic evaluation to inform management and family planning.

Coding Guidelines

Inclusion Criteria

Use Q13.2 When
  • According to ICD
  • 10 coding guidelines, congenital conditions should be coded based on the specific malformation and any associated conditions
  • Documentation must clearly support the diagnosis, including any relevant clinical findings and genetic evaluations

Exclusion Criteria

Do NOT use Q13.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used for routine follow-up of patients with congenital iris malformations.

Documentation Requirements

Documentation must include the reason for the visit, findings, and any treatment plans.

Specialty Considerations

Ophthalmologists should ensure that all findings related to the iris malformation are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the accuracy of data collection and reimbursement processes. Q13.2 provides a distinct code for other iris malformations, enhancing clarity in clinical documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the accuracy of data collection and reimbursement processes. Q13.2 provides a distinct code for other iris malformations, enhancing clarity in clinical documentation.

Reimbursement & Billing Impact

reimbursement processes. Q13.2 provides a distinct code for other iris malformations, enhancing clarity in clinical documentation.

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 congenital malformations of the iris?

Common congenital malformations of the iris include coloboma, aniridia, and other structural anomalies. Each condition has unique implications for vision and may require different management strategies.