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ICD-10 Guide
ICD-10 CodesH11.429

H11.429

Billable

Conjunctival edema, unspecified eye

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

Code Description

ICD-10 H11.429 is a billable code used to indicate a diagnosis of conjunctival edema, unspecified eye.

Key Diagnostic Point:

Conjunctival edema, unspecified eye, refers to the swelling of the conjunctiva, the thin membrane that covers the white part of the eyeball and the inner surface of the eyelids. This condition can manifest as redness, irritation, and a sensation of fullness or pressure in the affected eye. The conjunctiva plays a crucial role in protecting the eye and maintaining moisture. Edema can result from various underlying causes, including allergic reactions, infections, or systemic conditions such as hypertension. The disease progression may vary; acute cases may resolve quickly with appropriate treatment, while chronic edema may indicate ongoing inflammation or other serious conditions. Diagnostic considerations include a thorough patient history, physical examination, and possibly additional tests such as conjunctival scraping or allergy testing to determine the underlying cause. It is essential to differentiate conjunctival edema from other ocular disorders, such as scleral or corneal edema, which may require different management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

Specialty Focus

Medical Specialties

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

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 visual disturbances. It is essential for healthcare providers to recognize and manage this condition effectively to prevent complications. The prevalence of allergic conjunctivitis and other causes of conjunctival edema highlights the importance of understanding this condition in the context of population health. Effective management can reduce healthcare utilization and improve patient outcomes, making it a relevant focus in quality measures.

ICD-9 vs ICD-10

Conjunctival edema can significantly impact patient quality of life, leading to discomfort and visual disturbances. It is essential for healthcare providers to recognize and manage this condition effectively to prevent complications. The prevalence of allergic conjunctivitis and other causes of conjunctival edema highlights the importance of understanding this condition in the context of population health. Effective management can reduce healthcare utilization and improve patient outcomes, making it a relevant focus in quality measures.

Reimbursement & Billing Impact

reimbursement related to eye conditions.

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 H11.429?

H11.429 encompasses conjunctival edema due to various causes, including allergic conjunctivitis, viral or bacterial infections, and irritants. It does not specify the underlying etiology, making it a catch-all for unspecified conjunctival swelling.

When should H11.429 be used instead of related codes?

H11.429 should be used when the specific eye affected is not documented, or when the cause of the conjunctival edema is unknown. If the condition is localized to one eye or has a known etiology, more specific codes should be utilized.

What documentation supports H11.429?

Documentation should include a detailed patient history, clinical findings, and any diagnostic tests performed. Notes should clearly indicate the symptoms, duration, and any treatments attempted to support the use of H11.429.