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v1.0.0
ICD-10 Guide
ICD-10 CodesH16.221

H16.221

Billable

Keratoconjunctivitis sicca, not specified as Sjögren's, right eye

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

Code Description

ICD-10 H16.221 is a billable code used to indicate a diagnosis of keratoconjunctivitis sicca, not specified as sjögren's, right eye.

Key Diagnostic Point:

Keratoconjunctivitis sicca, not specified as Sjögren's, right eye

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity
Keratoconjunctivitis sicca can vary in severity and may require ongoing management. It often involves a multifactorial approach, including patient education, lifestyle modifications, and pharmacological interventions.

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 H16.221 When
  • Ensure accurate documentation of symptoms, duration, and any treatments provided
  • Distinguish between primary dry eye and secondary causes, and document any associated conditions
  • Use H16
  • 221 specifically for keratoconjunctivitis sicca not associated with Sjögren's syndrome

Exclusion Criteria

Do NOT use H16.221 When
No specific exclusions found.

Related ICD-10 Codes

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CPT Code

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Documentation Requirements

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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 is essential for appropriate reimbursement and to avoid claim denials. Misclassification may lead to under-treatment or inappropriate management strategies.

ICD-9 vs ICD-10

Accurate coding is essential for appropriate reimbursement and to avoid claim denials. Misclassification may lead to under-treatment or inappropriate management strategies.

Reimbursement & Billing Impact

reimbursement and to avoid claim denials. Misclassification may lead to under-treatment or inappropriate management strategies.

Resources

Clinical References

  • •
    Keratoconjunctivitis Sicca: A Comprehensive Review
  • •
    Dry Eye Disease: A Guide for Clinicians
  • •
    American Academy of Ophthalmology - Dry Eye Syndrome

Coding & Billing References

  • •
    Keratoconjunctivitis Sicca: A Comprehensive Review
  • •
    Dry Eye Disease: A Guide for Clinicians
  • •
    American Academy of Ophthalmology - Dry Eye Syndrome

Frequently Asked Questions

What are the common symptoms of keratoconjunctivitis sicca?

Common symptoms include dryness, irritation, redness, and a gritty sensation in the eye. Patients may also experience fluctuating vision.

How is keratoconjunctivitis sicca diagnosed?

Diagnosis typically involves a comprehensive eye examination, including patient history, symptom questionnaires, and tests such as tear break-up time or Schirmer's test.

What treatment options are available for keratoconjunctivitis sicca?

Treatment options may include artificial tears, anti-inflammatory medications, punctal plugs, and lifestyle modifications to reduce symptoms.