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v1.0.0
ICD-10 Guide
ICD-10 CodesR94.111

R94.111

Abnormal electroretinogram [ERG]

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

Code Description

ICD-10 R94.111 is a billable code used to indicate a diagnosis of abnormal electroretinogram [erg].

Key Diagnostic Point:

An abnormal electroretinogram (ERG) indicates a deviation from normal retinal function as assessed by this specialized test. The ERG measures the electrical responses of the retina's light-sensitive cells (photoreceptors) when exposed to light stimuli. Abnormal findings may suggest various retinal disorders, including retinitis pigmentosa, diabetic retinopathy, or other inherited retinal diseases. Symptoms associated with abnormal ERG results can include visual disturbances, night blindness, or peripheral vision loss. Clinicians often utilize ERG in conjunction with other diagnostic tests, such as optical coherence tomography (OCT) or visual field testing, to provide a comprehensive evaluation of retinal health. The interpretation of ERG results requires expertise, as variations can arise from factors such as patient age, systemic conditions, and medication effects. Accurate coding of R94.111 is essential for proper documentation of retinal dysfunction and guiding further management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Interpretation of ERG results requires specialized knowledge.
  • Differentiating between various retinal disorders can be complex.
  • Documentation must clearly link abnormal findings to clinical symptoms.
  • Potential overlap with other codes for retinal conditions.

Audit Risk Factors

  • Inadequate documentation linking ERG results to clinical findings.
  • Misinterpretation of ERG results leading to incorrect coding.
  • Failure to document prior tests or conditions that may affect ERG.
  • Coding without sufficient clinical correlation.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, including symptoms and previous ocular conditions, must be documented to support the diagnosis.

Common Clinical Scenarios

Patients presenting with visual disturbances or systemic diseases affecting vision.

Billing Considerations

Consideration of systemic conditions that may influence retinal health, such as diabetes or hypertension.

Emergency Medicine

Documentation Requirements

Acute care documentation must include immediate symptoms and any prior ocular history.

Common Clinical Scenarios

Patients with sudden vision loss or acute eye injuries requiring ERG for assessment.

Billing Considerations

Rapid assessment and documentation are critical in emergency settings to ensure appropriate follow-up.

Coding Guidelines

Inclusion Criteria

Use R94.111 When
  • Follow official ICD
  • CM guidelines for coding symptoms and abnormal findings
  • Ensure that the abnormal ERG is documented as part of a broader clinical picture, linking it to specific symptoms or conditions

Exclusion Criteria

Do NOT use R94.111 When
No specific exclusions found.

Related CPT Codes

92275CPT Code

Electroretinogram (ERG)

Clinical Scenario

Used when performing an ERG to assess retinal function.

Documentation Requirements

Document the indication for the ERG and any relevant patient history.

Specialty Considerations

Ophthalmology specialists should ensure proper coding based on the findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of abnormal findings, enhancing the ability to capture the nuances of retinal disorders and improving data accuracy for research and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of abnormal findings, enhancing the ability to capture the nuances of retinal disorders and improving data accuracy for research and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of abnormal findings, enhancing the ability to capture the nuances of retinal disorders and improving data accuracy for research and treatment outcomes.

Resources

Clinical References

  • •
    American Academy of Ophthalmology

Coding & Billing References

  • •
    American Academy of Ophthalmology

Frequently Asked Questions

What does an abnormal ERG indicate?

An abnormal ERG indicates potential dysfunction in the retina, which may be due to various conditions such as inherited retinal diseases, diabetic retinopathy, or other retinal pathologies.