ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesH11.423

H11.423

Billable

Conjunctival edema, bilateral

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 H11.423 is a billable code used to indicate a diagnosis of conjunctival edema, bilateral.

Key Diagnostic Point:

Conjunctival edema, bilateral, is characterized by swelling of the conjunctiva, the thin membrane covering the white part of the eye and the inner surface of the eyelids. This condition can arise from various etiologies, including allergic reactions, infections, or systemic diseases. Clinically, patients may present with redness, discomfort, and tearing, often accompanied by other symptoms such as itching or burning. The conjunctiva is a critical component of the anterior segment of the eye, which also includes the sclera and cornea. In cases of bilateral conjunctival edema, it is essential to evaluate for systemic causes, such as allergic conjunctivitis or conjunctival infections, which may require different management strategies. Diagnostic considerations include a thorough patient history, physical examination, and possibly laboratory tests to identify underlying causes. Disease progression can vary; if left untreated, conjunctival edema may lead to complications such as vision impairment or chronic discomfort. Therefore, timely diagnosis and appropriate management are crucial.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other conjunctival disorders.
  • Treatment complexity: May involve topical medications, systemic treatments, or referral to specialists.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis.
  • Coding specificity: Requires precise coding to reflect the bilateral nature of the condition.

Audit Risk Factors

  • Common coding errors: Misclassification with other conjunctival disorders.
  • Documentation gaps: Incomplete patient history or lack of symptom description.
  • Billing challenges: Potential for denials if the medical necessity is not clearly documented.

Specialty Focus

Medical Specialties

Primary medical specialty: Ophthalmology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Allergy and Immunology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Conjunctival edema can significantly impact patient quality of life, leading to discomfort and potential vision issues. Understanding the epidemiology of conjunctival disorders is essential for population health management, as allergic conjunctivitis and other related conditions are prevalent. Effective management of conjunctival edema can improve healthcare utilization patterns by reducing unnecessary visits and treatments, thereby enhancing overall patient outcomes and satisfaction.

ICD-9 vs ICD-10

Conjunctival edema can significantly impact patient quality of life, leading to discomfort and potential vision issues. Understanding the epidemiology of conjunctival disorders is essential for population health management, as allergic conjunctivitis and other related conditions are prevalent. Effective management of conjunctival edema can improve healthcare utilization patterns by reducing unnecessary visits and treatments, thereby enhancing overall patient outcomes and satisfaction.

Reimbursement & Billing Impact

Conjunctival edema can significantly impact patient quality of life, leading to discomfort and potential vision issues. Understanding the epidemiology of conjunctival disorders is essential for population health management, as allergic conjunctivitis and other related conditions are prevalent. Effective management of conjunctival edema can improve healthcare utilization patterns by reducing unnecessary visits and treatments, thereby enhancing overall patient outcomes and satisfaction.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by H11.423?

H11.423 covers bilateral conjunctival edema due to various causes, including allergic reactions, infections, and systemic conditions. It is important to differentiate it from unilateral cases and other conjunctival disorders.

When should H11.423 be used instead of related codes?

H11.423 should be used when the edema is bilateral and specifically documented as such. If the edema is unilateral, H11.421 should be selected. Accurate documentation of symptoms and clinical findings is essential for proper code selection.

What documentation supports H11.423?

Documentation should include a detailed patient history, clinical examination findings, and any diagnostic tests performed. Notes should clearly indicate the bilateral nature of the edema and any associated symptoms.