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v1.0.0
ICD-10 Guide
ICD-10 CodesH16.223

H16.223

Billable

Keratoconjunctivitis sicca, not specified as Sjögren's, bilateral

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

Code Description

ICD-10 H16.223 is a billable code used to indicate a diagnosis of keratoconjunctivitis sicca, not specified as sjögren's, bilateral.

Key Diagnostic Point:

Keratoconjunctivitis sicca, not specified as Sjögren's, bilateral

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity
Keratoconjunctivitis sicca can vary in severity from mild discomfort to significant visual impairment, requiring careful assessment and management strategies. The condition may involve multiple etiologies and necessitate a multidisciplinary approach for optimal patient outcomes.

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 H16.223 When
  • Ensure accurate documentation of symptoms, duration, and any previous treatments
  • Differentiate between primary and secondary causes of dry eye disease
  • Include relevant history and examination findings to support the diagnosis

Exclusion Criteria

Do NOT use H16.223 When
No specific exclusions found.

Related ICD-10 Codes

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CPT Code

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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 H16.223 impacts reimbursement for ophthalmic services. Misclassification may lead to claim denials or underpayment. Proper documentation supports the medical necessity of treatments and interventions.

ICD-9 vs ICD-10

Accurate coding of H16.223 impacts reimbursement for ophthalmic services. Misclassification may lead to claim denials or underpayment. Proper documentation supports the medical necessity of treatments and interventions.

Reimbursement & Billing Impact

reimbursement for ophthalmic services. Misclassification may lead to claim denials or underpayment. Proper documentation supports the medical necessity of treatments and interventions.

Resources

Clinical References

  • •
    Keratoconjunctivitis Sicca: A Review
  • •
    Dry Eye Disease: A Comprehensive Review
  • •
    Management of Dry Eye Disease

Coding & Billing References

  • •
    Keratoconjunctivitis Sicca: A Review
  • •
    Dry Eye Disease: A Comprehensive Review
  • •
    Management of Dry Eye Disease

Frequently Asked Questions

What are the common symptoms of keratoconjunctivitis sicca?

Common symptoms include dryness, burning, itching, redness, and a gritty sensation in the eyes.

How is keratoconjunctivitis sicca diagnosed?

Diagnosis typically involves a comprehensive eye examination, assessment of symptoms, and specific tests to measure tear production and quality.

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.