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ICD-10 Guide
ICD-10 CodesH16.059

H16.059

Billable

Mooren's corneal ulcer, unspecified eye

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

Code Description

ICD-10 H16.059 is a billable code used to indicate a diagnosis of mooren's corneal ulcer, unspecified eye.

Key Diagnostic Point:

Mooren's corneal ulcer is a rare, painful condition characterized by a progressive, unilateral or bilateral corneal ulceration that typically occurs in individuals aged 40-70 years. The condition is classified as a type of peripheral corneal ulceration and is believed to be autoimmune in nature, leading to the destruction of corneal tissue. The cornea, a transparent layer at the front of the eye, plays a crucial role in vision and is composed of several layers, including the epithelium, stroma, and endothelium. Patients may present with symptoms such as severe eye pain, redness, photophobia, and vision impairment. Disease progression can lead to corneal perforation and subsequent vision loss if not treated promptly. Diagnosis is primarily clinical, supported by slit-lamp examination revealing characteristic features of the ulcer. Differential diagnoses include other causes of corneal ulcers, such as infectious keratitis or chemical burns. Early recognition and management are essential to prevent complications and preserve vision.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other corneal disorders.
  • Treatment complexity: May involve topical medications, surgical intervention, or referral to specialists.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires accurate coding to reflect the specific nature of the ulcer.

Audit Risk Factors

  • Common coding errors: Misidentification of the ulcer type or eye involved.
  • Documentation gaps: Incomplete clinical notes may lead to denials.
  • Billing challenges: Potential for reimbursement issues due to lack of specificity.

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

Mooren's corneal ulcer can significantly affect a patient's quality of life due to pain and vision impairment. Its rarity makes it a less understood condition, potentially leading to delays in diagnosis and treatment. Understanding its epidemiology is crucial for healthcare providers, as early intervention can prevent severe complications. Awareness of this condition can improve healthcare utilization patterns and inform public health strategies aimed at eye health.

ICD-9 vs ICD-10

Mooren's corneal ulcer can significantly affect a patient's quality of life due to pain and vision impairment. Its rarity makes it a less understood condition, potentially leading to delays in diagnosis and treatment. Understanding its epidemiology is crucial for healthcare providers, as early intervention can prevent severe complications. Awareness of this condition can improve healthcare utilization patterns and inform public health strategies aimed at eye health.

Reimbursement & Billing Impact

reimbursement.

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 H16.059?

H16.059 covers Mooren's corneal ulcer without specifying the eye affected. It includes cases where the ulcer is not clearly defined as right or left, and it may also encompass cases with bilateral involvement.

When should H16.059 be used instead of related codes?

H16.059 should be used when the specific eye affected is not documented or when the condition is bilateral. If the eye is specified, use H16.051 or H16.052 accordingly.

What documentation supports H16.059?

Documentation should include a detailed clinical examination, symptoms reported by the patient, diagnostic imaging results, and treatment plans. Notes should clearly indicate the nature of the ulcer and any relevant history.