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ICD-10 Guide
ICD-10 CodesH11.829

H11.829

Billable

Conjunctivochalasis, unspecified eye

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

Code Description

ICD-10 H11.829 is a billable code used to indicate a diagnosis of conjunctivochalasis, unspecified eye.

Key Diagnostic Point:

Conjunctivochalasis is a condition characterized by the presence of redundant conjunctival tissue that can lead to ocular discomfort and visual disturbances. It primarily affects the conjunctiva, which is the thin membrane covering the white part of the eye and the inner surface of the eyelids. Clinically, patients may present with symptoms such as dryness, irritation, and a sensation of a foreign body in the eye. The condition can be exacerbated by environmental factors, prolonged screen time, or underlying conditions like dry eye syndrome. The disease progression may vary, with some patients experiencing mild symptoms while others may develop significant discomfort and visual impairment. Diagnostic considerations include a thorough ocular examination, where the clinician assesses the conjunctiva's appearance and may utilize fluorescein staining to evaluate tear film stability. Treatment options range from conservative measures, such as artificial tears, to surgical interventions in severe cases. Understanding the anatomy involved, including the conjunctiva, sclera, and anterior segment structures, is crucial for effective management and patient education.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors include misidentifying the eye affected or confusing conjunctivochalasis with other conjunctival disorders.
  • Documentation gaps may arise from insufficient detail regarding symptoms or treatment plans.
  • Billing challenges can occur if the condition is not clearly documented, leading to potential denials.

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 increased healthcare utilization due to frequent visits for symptom management. Understanding its prevalence in the population is crucial for developing effective treatment protocols and quality measures. Epidemiologically, conjunctivochalasis is often underdiagnosed, which may lead to unnecessary suffering and healthcare costs associated with untreated ocular surface disorders.

ICD-9 vs ICD-10

Conjunctivochalasis can significantly affect patients' quality of life, leading to increased healthcare utilization due to frequent visits for symptom management. Understanding its prevalence in the population is crucial for developing effective treatment protocols and quality measures. Epidemiologically, conjunctivochalasis is often underdiagnosed, which may lead to unnecessary suffering and healthcare costs associated with untreated ocular surface disorders.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for ophthalmic evaluations and treatments. Common denials may arise from insufficient documentation or lack of medical necessity for the services rendered. Best practices include maintaining thorough records of patient interactions, treatment plans, and follow-up care to support claims and reduce the risk of audits.

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 H11.829?

H11.829 covers conjunctivochalasis without specifying the eye affected. It may also encompass cases where the condition presents with associated symptoms but lacks a definitive diagnosis of other conjunctival disorders.

When should H11.829 be used instead of related codes?

H11.829 should be used when the clinician cannot specify which eye is affected or when the condition is bilateral but not documented as such. It is also appropriate when the symptoms do not warrant a more specific diagnosis.

What documentation supports H11.829?

Documentation should include a detailed patient history, symptom description, clinical findings from the ocular examination, and any treatments attempted. Evidence of the impact on the patient's quality of life may also be beneficial.