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v1.0.0
ICD-10 Guide
ICD-10 CodesQ14.0

Q14.0

Billable

Congenital malformation of vitreous humor

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

Code Description

ICD-10 Q14.0 is a billable code used to indicate a diagnosis of congenital malformation of vitreous humor.

Key Diagnostic Point:

Congenital malformation of the vitreous humor refers to a range of developmental anomalies affecting the gel-like substance that fills the eye between the lens and the retina. These malformations can lead to various visual impairments, including reduced vision or blindness, depending on the severity and associated ocular anomalies. The vitreous humor plays a crucial role in maintaining the shape of the eye and supporting the retina. Congenital malformations may occur in isolation or as part of syndromic conditions, such as anophthalmia or microphthalmia, where the eye itself is underdeveloped or absent. The presence of associated anomalies, such as cleft lip or palate, can complicate the clinical picture and necessitate a multidisciplinary approach to management. Accurate diagnosis often involves imaging studies and genetic evaluation to identify any underlying chromosomal abnormalities that may contribute to the malformation. Early intervention is critical to optimize visual outcomes and address any associated developmental concerns.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of malformations
  • Need for comprehensive documentation of associated conditions
  • Potential for syndromic associations requiring genetic evaluation
  • Differentiation from other ocular conditions

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to specify the severity of the malformation
  • Misclassification of the condition as acquired rather than congenital
  • Lack of genetic testing results in the medical record

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed descriptions of the child's visual function, any associated developmental delays, and family history of congenital conditions.

Common Clinical Scenarios

Common scenarios include a newborn presenting with visual impairment, requiring assessment for congenital eye anomalies, or a child with a known family history of ocular malformations.

Billing Considerations

Considerations include the need for early referral to pediatric ophthalmology and potential involvement of genetic counseling services.

Genetics

Documentation Requirements

Genetic documentation should include results from chromosomal analysis, family pedigree, and any syndromic associations identified during evaluation.

Common Clinical Scenarios

Scenarios may involve a child with congenital malformations being evaluated for genetic syndromes or a family seeking counseling after a diagnosis of a congenital eye anomaly.

Billing Considerations

Genetic coding must accurately reflect any identified chromosomal abnormalities and their implications for the patient's overall health.

Coding Guidelines

Inclusion Criteria

Use Q14.0 When
  • Official coding guidelines for congenital conditions emphasize the importance of accurate documentation of the malformation, associated anomalies, and any genetic evaluations performed
  • Coders should ensure that the diagnosis is clearly linked to the clinical findings and any relevant imaging studies

Exclusion Criteria

Do NOT use Q14.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

66984CPT Code

Extracapsular cataract removal with insertion of intraocular lens

Clinical Scenario

Used in cases where congenital cataracts are present alongside vitreous malformations.

Documentation Requirements

Document the indication for surgery, including visual impairment and associated congenital conditions.

Specialty Considerations

Ophthalmology should ensure thorough preoperative assessments and genetic evaluations 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 ability to capture the complexity of these conditions and their associated anomalies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the ability to capture the complexity of these conditions and their associated anomalies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the ability to capture the complexity of these conditions and their associated anomalies.

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 Q14.0?

Common associated conditions include anophthalmia, microphthalmia, and other congenital anomalies of the eye, as well as syndromic conditions that may involve multiple systems, necessitating a multidisciplinary approach to care.