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ICD-10 Guide
ICD-10 CodesH11.82

H11.82

Non-billable

Conjunctivochalasis

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

Code Description

ICD-10 H11.82 is a used to indicate a diagnosis of conjunctivochalasis.

Key Diagnostic Point:

Conjunctivochalasis is a condition characterized by the redundancy of conjunctival tissue, which can lead to ocular discomfort and visual disturbances. Clinically, patients may present with symptoms such as dryness, irritation, and a sensation of a foreign body in the eye. The conjunctiva, a thin membrane covering the sclera and lining the eyelids, becomes lax, often due to aging or chronic inflammation. This laxity can interfere with tear film stability, leading to symptoms of dry eye syndrome. The disease progression may vary; in some cases, it remains stable, while in others, it can worsen, necessitating surgical intervention. Diagnostic considerations include a thorough ocular examination, where slit-lamp biomicroscopy may reveal the characteristic folds of conjunctival tissue. Additionally, tear break-up time tests may be performed to assess the impact on tear film stability. Understanding the anatomy involved—specifically the conjunctiva, sclera, and their relationship to the cornea and anterior segment—is crucial for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a comprehensive eye examination and understanding of ocular surface disorders.
  • Treatment complexity: Management may involve conservative measures or surgical options, depending on severity.
  • Documentation requirements: Detailed clinical notes are essential to justify the diagnosis and treatment.
  • Coding specificity: Requires accurate coding to differentiate from other conjunctival and ocular surface disorders.

Audit Risk Factors

  • Common coding errors: Misclassification with other conjunctival disorders.
  • Documentation gaps: Insufficient detail in clinical notes regarding symptoms and examination findings.
  • Billing challenges: Potential denials if the medical necessity for treatment is not clearly documented.

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

Optometry

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

Conjunctivochalasis can significantly affect patients' quality of life, leading to discomfort and visual disturbances. Its prevalence increases with age, making it a relevant concern in population health. Understanding this condition is crucial for improving patient outcomes and reducing healthcare utilization related to ocular surface disorders. Quality measures may include tracking treatment efficacy and patient-reported outcomes to enhance care strategies.

ICD-9 vs ICD-10

Conjunctivochalasis can significantly affect patients' quality of life, leading to discomfort and visual disturbances. Its prevalence increases with age, making it a relevant concern in population health. Understanding this condition is crucial for improving patient outcomes and reducing healthcare utilization related to ocular surface disorders. Quality measures may include tracking treatment efficacy and patient-reported outcomes to enhance care strategies.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the medical necessity of treatments, particularly if surgical intervention is required. Common denials may arise from insufficient documentation or failure to demonstrate the impact on the patient's quality of life. Coding best practices involve using the most specific code available and ensuring that all relevant clinical information is included in the claim to avoid delays or denials.

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 H11.82?

H11.82 specifically covers conjunctivochalasis, which may be associated with dry eye syndrome and other ocular surface disorders. It is important to differentiate it from other conditions like conjunctivitis or pterygium.

When should H11.82 be used instead of related codes?

H11.82 should be used when the primary issue is the redundancy of conjunctival tissue leading to symptoms. If the condition involves other factors, such as inflammation or infection, other codes may be more appropriate.

What documentation supports H11.82?

Documentation should include a detailed history of symptoms, results from ocular examinations, and any tests performed to assess tear film stability. Notes should clearly indicate the diagnosis and rationale for treatment.