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v1.0.0
ICD-10 Guide
ICD-10 CodesH16.209

H16.209

Billable

Unspecified keratoconjunctivitis, unspecified eye

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

Code Description

ICD-10 H16.209 is a billable code used to indicate a diagnosis of unspecified keratoconjunctivitis, unspecified eye.

Key Diagnostic Point:

Unspecified keratoconjunctivitis, unspecified eye

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity
Unspecified keratoconjunctivitis can range from mild to severe symptoms, requiring careful assessment to determine the underlying cause and appropriate treatment. It may involve a variety of etiologies including allergic, viral, or bacterial origins.

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

Coding Guidelines

Inclusion Criteria

Use H16.209 When
  • When coding for unspecified keratoconjunctivitis, ensure that the documentation clearly states the diagnosis
  • If specific types of keratoconjunctivitis are identified later, consider updating the code to reflect the specific condition
  • Always document the patient's symptoms and any treatments provided

Exclusion Criteria

Do NOT use H16.209 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

CPT Code

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Documentation Requirements

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

Accurate coding of H16.209 is crucial for appropriate reimbursement and to avoid claim denials. Misclassification may lead to under-treatment or over-treatment of the condition, impacting patient outcomes.

ICD-9 vs ICD-10

Accurate coding of H16.209 is crucial for appropriate reimbursement and to avoid claim denials. Misclassification may lead to under-treatment or over-treatment of the condition, impacting patient outcomes.

Reimbursement & Billing Impact

reimbursement and to avoid claim denials. Misclassification may lead to under-treatment or over-treatment of the condition, impacting patient outcomes.

Resources

Clinical References

  • •
    American Academy of Ophthalmology - Keratoconjunctivitis
  • •
    National Eye Institute - Conjunctivitis
  • •
    American Optometric Association - Conjunctivitis Overview

Coding & Billing References

  • •
    American Academy of Ophthalmology - Keratoconjunctivitis
  • •
    National Eye Institute - Conjunctivitis
  • •
    American Optometric Association - Conjunctivitis Overview

Frequently Asked Questions

What are the common symptoms of unspecified keratoconjunctivitis?

Common symptoms include redness, itching, tearing, and discharge from the eye. Patients may also experience blurred vision or a gritty sensation.

How is unspecified keratoconjunctivitis treated?

Treatment may vary based on the underlying cause but can include antihistamines for allergic conjunctivitis, antibiotic drops for bacterial infections, or supportive care for viral conjunctivitis.

When should I refer a patient with keratoconjunctivitis to a specialist?

Referral to an ophthalmologist is recommended if the patient exhibits severe symptoms, does not respond to initial treatment, or has recurrent episodes.