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v1.0.0
ICD-10 Guide
DiagnosesKeratoconus

Keratoconus

ICD-10 Coding for Keratoconus(H18.611, H18.621)

PRIMARY SPECIALTYOphthalmology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Keratoconus?
Essential facts and insights about Keratoconus

Key Clinical Considerations:

  • Irregular corneal shape leading to visual distortion
  • Slit-lamp examination revealing cone-shaped cornea
  • Corneal topography showing steepening of the cornea

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including symptoms and duration
  • Results of corneal topography and visual acuity tests
  • Notes on any previous treatments or interventions

Coding Guidelines

Usage Guidelines & Examples

  • Use H18.603 for unspecified cases; specify laterality with H18.601 or H18.602.
  • Common errors include using incorrect laterality codes or omitting diagnostic tests.

Code Exclusions

Important Exclusions

  • Other corneal dystrophies and conditions like pellucid marginal degeneration
  • Alternative codes for corneal ectasia or other refractive errors

Related ICD-10 Codes

Primary Codes
H18.603
Keratoconus, unspecified eye
H18.601
Keratoconus, right eye
H18.602
Keratoconus, left eye
Ancillary Codes
Z94.7
Differential Codes
H18.621
H18.621
if there is recent hydrops or rapid progression (>2D steepening in 6 months).
H18.611
H18.611
if the condition is stable with <1D change over 12 months.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Ophthalmology

Specialty Applications

  • Patients with progressive vision changes, typically ages 10-25
  • Ophthalmology clinics, optometry practices, and specialty eye centers

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Include patient history, examination findings, and diagnostic test results.

What are the billing considerations?

Ensure accurate coding based on eye affected and severity of keratoconus.