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ICD-10 Guide
ICD-10 CodesH11.822

H11.822

Billable

Conjunctivochalasis, left eye

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

Code Description

ICD-10 H11.822 is a billable code used to indicate a diagnosis of conjunctivochalasis, left eye.

Key Diagnostic Point:

Conjunctivochalasis is a condition characterized by the excessive redundancy of the conjunctiva, which can lead to discomfort and visual disturbances. It primarily affects the left eye in this code designation. The conjunctiva is a thin, transparent membrane that covers the sclera and lines the eyelids, playing a crucial role in eye lubrication and protection. In conjunctivochalasis, the conjunctiva becomes lax and can fold over itself, potentially causing irritation to the cornea and impacting the anterior segment of the eye. Patients may present with symptoms such as foreign body sensation, tearing, and blurred vision. The condition can progress if left untreated, leading to chronic inflammation or corneal damage. Diagnosis typically involves a comprehensive eye examination, including slit-lamp evaluation to assess the extent of conjunctival redundancy and its effect on the ocular surface. Differential diagnoses may include pterygium, pinguecula, and other conjunctival disorders. Proper identification is essential for effective management and to prevent complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough examination and differentiation from similar conditions.
  • Treatment complexity: May involve conservative management or surgical intervention depending on severity.
  • Documentation requirements: Detailed clinical notes are necessary to support diagnosis and treatment.
  • Coding specificity: Requires precise coding to indicate laterality and specific condition.

Audit Risk Factors

  • Common coding errors: Misidentification of laterality or confusion with similar conjunctival conditions.
  • Documentation gaps: Insufficient clinical notes to justify the diagnosis or treatment plan.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Conjunctivochalasis can significantly affect a patient's quality of life, leading to discomfort and visual impairment. Understanding its prevalence and impact on population health is essential for healthcare providers. Effective management can improve patient outcomes and reduce healthcare utilization associated with complications from untreated conjunctivochalasis. Awareness of this condition contributes to better quality measures in ophthalmic care.

ICD-9 vs ICD-10

Conjunctivochalasis can significantly affect a patient's quality of life, leading to discomfort and visual impairment. Understanding its prevalence and impact on population health is essential for healthcare providers. Effective management can improve patient outcomes and reduce healthcare utilization associated with complications from untreated conjunctivochalasis. Awareness of this condition contributes to better quality measures in ophthalmic care.

Reimbursement & Billing Impact

Reimbursement considerations include verifying patient eligibility and ensuring that the procedure codes used align with the diagnosis. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for treatment. Best practices include maintaining thorough clinical notes, ensuring accurate coding, and understanding payer-specific requirements to minimize billing challenges.

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 H11.822?

H11.822 specifically covers conjunctivochalasis of the left eye, which is characterized by redundant conjunctival tissue that may cause ocular discomfort and visual disturbances. It is important to differentiate it from other conjunctival conditions such as pterygium and pinguecula.

When should H11.822 be used instead of related codes?

H11.822 should be used when the condition specifically affects the left eye and is diagnosed as conjunctivochalasis. It is important to use this code when the clinical presentation aligns with the criteria for conjunctivochalasis, distinguishing it from other conjunctival disorders.

What documentation supports H11.822?

Documentation should include a detailed clinical examination report, noting symptoms, findings from slit-lamp examination, and any treatments attempted. It should also clarify the diagnosis of conjunctivochalasis and its impact on the patient's ocular health.