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ICD-10 Guide
ICD-10 CodesQ13.3

Q13.3

Billable

Congenital corneal opacity

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q13.3 is a billable code used to indicate a diagnosis of congenital corneal opacity.

Key Diagnostic Point:

Congenital corneal opacity refers to a condition where the cornea, the clear front part of the eye, is clouded at birth. This opacity can result from various congenital malformations, including genetic syndromes, infections during pregnancy, or developmental anomalies. The severity of corneal opacity can vary, impacting visual acuity and leading to potential complications such as amblyopia or strabismus. Congenital corneal opacities may be isolated or associated with other ocular anomalies, such as anophthalmia (absence of one or both eyes) or microphthalmia (abnormally small eyes). Diagnosis typically involves a comprehensive eye examination, and management may include surgical interventions, such as corneal transplantation, to restore vision. Early detection and intervention are crucial to optimize visual outcomes in affected infants and children.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of corneal opacity
  • Potential association with other congenital anomalies
  • Need for detailed documentation of visual impairment
  • Differentiation from acquired corneal opacities

Audit Risk Factors

  • Inadequate documentation of visual impairment severity
  • Failure to document associated congenital anomalies
  • Misclassification of congenital versus acquired conditions
  • Lack of genetic testing results in the medical record

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed visual assessments, family history of congenital conditions, and any associated syndromic features.

Common Clinical Scenarios

Common scenarios include infants presenting with cloudy corneas during routine examinations or referrals from pediatricians for suspected congenital eye conditions.

Billing Considerations

Coders should ensure that all associated conditions are documented to support the complexity of care and potential surgical interventions.

Genetics

Documentation Requirements

Genetic documentation should include results from chromosomal analysis, family history, and any syndromic associations that may impact management.

Common Clinical Scenarios

Genetic counseling sessions for families with a history of congenital eye anomalies or syndromes associated with corneal opacity.

Billing Considerations

Consideration of genetic syndromes that may present with corneal opacity is essential for accurate coding and management.

Coding Guidelines

Inclusion Criteria

Use Q13.3 When
  • According to ICD
  • 10 coding guidelines, congenital conditions should be coded based on the specific malformation and any associated conditions
  • Documentation must support the diagnosis and any interventions performed

Exclusion Criteria

Do NOT use Q13.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

66984CPT Code

Corneal transplant, penetrating

Clinical Scenario

Used in cases of severe congenital corneal opacity requiring surgical intervention.

Documentation Requirements

Document indications for surgery, visual impairment severity, and pre-operative assessments.

Specialty Considerations

Ophthalmology should provide detailed surgical notes and post-operative care plans.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes for congenital corneal opacity and associated anomalies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes for congenital corneal opacity and associated anomalies.

Reimbursement & Billing Impact

reimbursement processes for congenital corneal opacity and associated anomalies.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding congenital corneal opacity?

Accurate coding of congenital corneal opacity is crucial for appropriate management, treatment planning, and understanding the prevalence of congenital eye conditions. It also aids in research and resource allocation for affected populations.