Macular keratitis, bilateral
ICD-10 H16.113 is a billable code used to indicate a diagnosis of macular keratitis, bilateral.
Macular keratitis, bilateral, is characterized by inflammation of the cornea, specifically affecting the macula region, which is crucial for central vision. Clinically, patients may present with symptoms such as blurred vision, ocular discomfort, photophobia, and redness. The anatomy involved includes the cornea, conjunctiva, and potentially the anterior segment of the eye, which encompasses the iris and lens. Disease progression can vary; if untreated, macular keratitis may lead to corneal scarring and permanent vision loss. Diagnostic considerations include a thorough ocular examination, slit-lamp biomicroscopy, and possibly corneal scraping for microbiological analysis to rule out infectious causes. The bilateral nature of this condition suggests a systemic or environmental factor, necessitating a comprehensive patient history and examination to identify underlying causes such as autoimmune disorders or exposure to irritants. Accurate diagnosis is crucial for effective management and treatment planning.
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
H16.113 specifically covers bilateral macular keratitis, which may arise from various etiologies including infectious agents, environmental factors, or autoimmune conditions. It is essential to differentiate this from other types of keratitis, such as viral or bacterial keratitis, which may require different management.
H16.113 should be used when the condition is confirmed as bilateral macular keratitis. If the keratitis is unilateral or of a different type, other codes such as H16.112 or H16.10 should be considered. Accurate clinical documentation is vital for appropriate code selection.
Documentation should include a comprehensive ocular examination report, patient history detailing symptoms and potential exposure risks, and any laboratory results that support the diagnosis of bilateral macular keratitis. Detailed notes on treatment plans and patient responses are also beneficial.
