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ICD-10 Guide
ICD-10 CodesChapter 7: Diseases of the eye and adnexaH16

H16

Non-billable

Keratitis

Chapter 7:Diseases of the eye and adnexa

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 H16 is a used to indicate a diagnosis of keratitis.

Key Diagnostic Point:

Keratitis refers to the inflammation of the cornea, which can result from various causes including infections, exposure to UV light, or underlying systemic diseases. This condition can manifest in several forms, such as bacterial keratitis, viral keratitis (often due to herpes simplex virus), and fungal keratitis. Each type presents unique clinical features and requires specific management strategies. Keratitis can lead to significant complications, including corneal scarring, vision loss, and in severe cases, perforation of the cornea, making early diagnosis and treatment crucial for preserving vision.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of causative agents
  • Differential diagnosis complexity
  • Treatment variability based on etiology

Audit Risk Factors

  • Misdiagnosis leading to incorrect coding
  • Inadequate documentation of the type of keratitis
  • Failure to capture associated complications

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

Primary Care

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 CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

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CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical impact of the H16 category is significant, as timely and accurate coding can influence treatment outcomes and patient management strategies. Proper identification of keratitis types can lead to targeted therapies, reducing the risk of complications such as vision loss. Administratively, accurate coding and billing practices are crucial for maintaining revenue cycles and ensuring compliance with healthcare regulations. As healthcare trends evolve, understanding the implications of keratitis on population health and quality measures will be increasingly important for ophthalmology practices.

ICD-9 vs ICD-10

The clinical impact of the H16 category is significant, as timely and accurate coding can influence treatment outcomes and patient management strategies. Proper identification of keratitis types can lead to targeted therapies, reducing the risk of complications such as vision loss. Administratively, accurate coding and billing practices are crucial for maintaining revenue cycles and ensuring compliance with healthcare regulations. As healthcare trends evolve, understanding the implications of keratitis on population health and quality measures will be increasingly important for ophthalmology practices.

Reimbursement & Billing Impact

billing practices are crucial for maintaining revenue cycles and ensuring compliance with healthcare regulations. As healthcare trends evolve, understanding the implications of keratitis on population health and quality measures will be increasingly important for ophthalmology practices.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for H16

Coding & Billing References

  • •
    Official ICD-10 Guidelines for H16

Frequently Asked Questions

What conditions are included in H16?

The H16 category includes various types of keratitis, such as bacterial, viral, fungal, and other specified keratitis types. It also encompasses keratitis due to exposure to ultraviolet light and keratitis associated with systemic diseases.

When should I use H16 codes?

H16 codes should be used when documenting cases of keratitis, particularly when the type of keratitis is specified. It is important to use these codes when the condition is diagnosed and when treatment is initiated.

What documentation is required for H16?

Documentation must include the type of keratitis diagnosed, the clinical findings, any relevant history, and the treatment plan. This ensures accurate coding and supports the medical necessity of the services provided.