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ICD-10 Guide
ICD-10 CodesQ14.3

Q14.3

Billable

Congenital malformation of choroid

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

Code Description

ICD-10 Q14.3 is a billable code used to indicate a diagnosis of congenital malformation of choroid.

Key Diagnostic Point:

Congenital malformation of the choroid refers to a range of developmental anomalies affecting the choroidal layer of the eye, which is crucial for providing blood supply to the retina. These malformations can lead to visual impairment or blindness, depending on their severity and associated conditions. The choroid is a vascular layer located between the retina and the sclera, and its malformations can occur in isolation or as part of syndromic presentations involving other ocular structures. Commonly associated congenital conditions include anophthalmia (absence of one or both eyes), microphthalmia (abnormally small eyes), and other ocular anomalies. The impact of these malformations can vary significantly, necessitating a multidisciplinary approach for management, including pediatric ophthalmology, genetics, and rehabilitation services. Early diagnosis and intervention are critical for optimizing visual outcomes and addressing any associated systemic issues.

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 additional coding
  • Differentiation from other ocular conditions

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Misclassification of severity or type of malformation
  • Failure to capture syndromic associations
  • Lack of clarity in clinical notes regarding visual impairment

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed pediatric history, including prenatal factors, family history of congenital conditions, and developmental milestones.

Common Clinical Scenarios

Evaluation of newborns with suspected congenital eye anomalies, follow-up assessments for visual development, and referrals for surgical interventions.

Billing Considerations

Consideration of the child's overall health and any associated systemic conditions that may impact management.

Genetics

Documentation Requirements

Genetic testing results, family pedigree analysis, and documentation of any syndromic features.

Common Clinical Scenarios

Genetic counseling for families with a history of congenital eye anomalies and assessment for potential chromosomal abnormalities.

Billing Considerations

Understanding the genetic basis of congenital malformations and the implications for family planning.

Coding Guidelines

Inclusion Criteria

Use Q14.3 When
  • Follow ICD
  • CM guidelines for coding congenital conditions, ensuring accurate documentation of the malformation's nature, associated conditions, and any relevant family history

Exclusion Criteria

Do NOT use Q14.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92002CPT Code

Ophthalmological examination, new patient

Clinical Scenario

Used for initial evaluation of a child with congenital malformations of the eye.

Documentation Requirements

Complete history and examination findings, including visual acuity and ocular health.

Specialty Considerations

Pediatric ophthalmologists should document any findings related to congenital anomalies.

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.

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.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Coding for Pediatric Care

Coding & Billing References

  • •
    American Academy of Pediatrics - Coding for Pediatric Care

Frequently Asked Questions

What is the significance of coding congenital malformations accurately?

Accurate coding of congenital malformations is crucial for appropriate patient management, resource allocation, and understanding the epidemiology of these conditions. It also impacts reimbursement and the ability to track outcomes in pediatric populations.