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ICD-10 Guide
ICD-10 CodesH16.123

H16.123

Billable

Filamentary keratitis, bilateral

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

Code Description

ICD-10 H16.123 is a billable code used to indicate a diagnosis of filamentary keratitis, bilateral.

Key Diagnostic Point:

Filamentary keratitis is a condition characterized by the presence of fine, thread-like strands of epithelial tissue that can adhere to the corneal surface, leading to irritation and inflammation. This condition typically affects both eyes (bilateral) and is often associated with underlying dry eye syndrome, exposure keratopathy, or other ocular surface disorders. The cornea, which is the transparent front part of the eye, becomes compromised due to the presence of these filaments, resulting in symptoms such as foreign body sensation, redness, tearing, and blurred vision. The conjunctiva and sclera may also exhibit signs of irritation due to the inflammatory response. Disease progression can lead to corneal scarring or ulceration if not managed appropriately. Diagnosis is primarily clinical, relying on slit-lamp examination to visualize the filaments and assess the extent of corneal involvement. Additional diagnostic tests may include tear break-up time and ocular surface staining to evaluate the overall health of the anterior segment. Early recognition and treatment are crucial to prevent complications and preserve visual function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Filamentary keratitis can significantly impact patients' quality of life due to discomfort and visual disturbances. It is prevalent in populations with dry eye syndrome, particularly among older adults and those with certain systemic conditions. Understanding the epidemiology of this condition can help healthcare providers implement preventive measures and improve management strategies, ultimately enhancing patient outcomes and reducing healthcare utilization related to complications.

ICD-9 vs ICD-10

Filamentary keratitis can significantly impact patients' quality of life due to discomfort and visual disturbances. It is prevalent in populations with dry eye syndrome, particularly among older adults and those with certain systemic conditions. Understanding the epidemiology of this condition can help healthcare providers implement preventive measures and improve management strategies, ultimately enhancing patient outcomes and reducing healthcare utilization related to complications.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, so it is crucial to verify coverage policies related to bilateral procedures. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include thorough documentation of the clinical findings, treatment plans, and patient follow-up to support the billing process 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 H16.123?

H16.123 specifically covers filamentary keratitis affecting both eyes, which may arise from various underlying conditions such as dry eye syndrome, exposure keratopathy, or chronic ocular surface disease. It is important to differentiate this from other forms of keratitis that may not involve filamentary strands.

When should H16.123 be used instead of related codes?

H16.123 should be used when the clinician confirms filamentary keratitis affecting both eyes. If the condition is unilateral, the appropriate unilateral codes (H16.121 or H16.122) should be utilized. Accurate documentation of bilateral involvement is essential for correct coding.

What documentation supports H16.123?

Documentation should include a detailed clinical examination report, noting the presence of filaments on the cornea, symptoms reported by the patient, and any underlying conditions contributing to the keratitis. Treatment plans and follow-up assessments should also be documented to support the diagnosis.