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ICD-10 Guide
ICD-10 CodesH16.242

H16.242

Billable

Ophthalmia nodosa, left eye

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

Code Description

ICD-10 H16.242 is a billable code used to indicate a diagnosis of ophthalmia nodosa, left eye.

Key Diagnostic Point:

Ophthalmia nodosa, left eye

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity
Ophthalmia nodosa can present with variable clinical features, including conjunctival inflammation and corneal involvement. Diagnosis may require careful examination and differentiation from other ocular conditions, making it moderately complex.

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 H16.242 When
  • When coding for ophthalmia nodosa, ensure that the documentation clearly states the affected eye (left eye in this case) and includes details of the clinical findings
  • Use additional codes as necessary to capture any associated conditions

Exclusion Criteria

Do NOT use H16.242 When
No specific exclusions found.

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CPT Code

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CPT Code

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CPT Code

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Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Accurate coding of H16.242 is crucial for appropriate reimbursement and to reflect the severity of the patient's condition. Misclassification can lead to denials or delays in payment.

ICD-9 vs ICD-10

Accurate coding of H16.242 is crucial for appropriate reimbursement and to reflect the severity of the patient's condition. Misclassification can lead to denials or delays in payment.

Reimbursement & Billing Impact

reimbursement and to reflect the severity of the patient's condition. Misclassification can lead to denials or delays in payment.

Resources

Clinical References

  • •
    Ophthalmia Nodosa: Clinical Overview
  • •
    American Academy of Ophthalmology: Coding for Eye Care

Coding & Billing References

  • •
    Ophthalmia Nodosa: Clinical Overview
  • •
    American Academy of Ophthalmology: Coding for Eye Care

Frequently Asked Questions

What are the common symptoms of ophthalmia nodosa?

Common symptoms include redness, irritation, tearing, and potential vision changes in the affected eye.

How is ophthalmia nodosa treated?

Treatment may involve topical medications, systemic therapy, and in some cases, surgical intervention depending on the severity of the condition.

Is ophthalmia nodosa a contagious condition?

No, ophthalmia nodosa is not contagious; it is typically a reaction to foreign bodies or irritants in the eye.