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ICD-10 Guide
ICD-10 CodesR94.11

R94.11

Abnormal results of function studies of eye

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

Code Description

ICD-10 R94.11 is a billable code used to indicate a diagnosis of abnormal results of function studies of eye.

Key Diagnostic Point:

R94.11 is used to classify abnormal results from function studies of the eye, which may include tests assessing visual acuity, color vision, contrast sensitivity, and other ocular functions. These tests are crucial in diagnosing various ocular conditions, including refractive errors, retinal diseases, and neurological disorders affecting vision. Abnormal results may indicate underlying pathologies such as glaucoma, diabetic retinopathy, or optic nerve damage. The interpretation of these results requires a comprehensive understanding of ocular anatomy and physiology, as well as the specific testing methodologies employed. Clinicians must correlate abnormal findings with clinical symptoms and patient history to arrive at an accurate diagnosis and treatment plan.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in function study methodologies and interpretations
  • Need for correlation with clinical symptoms and history
  • Potential overlap with other ocular conditions requiring different codes
  • Documentation of specific tests performed and their results

Audit Risk Factors

  • Inadequate documentation of specific tests performed
  • Failure to correlate abnormal findings with clinical symptoms
  • Misuse of the code when results are normal or not clearly abnormal
  • Inconsistent coding practices across different specialties

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of patient history, symptoms, and specific tests performed is essential.

Common Clinical Scenarios

Patients presenting with visual disturbances, headaches, or systemic diseases affecting vision.

Billing Considerations

Consideration of comorbid conditions that may affect ocular function.

Emergency Medicine

Documentation Requirements

Acute care documentation must include immediate findings and rationale for function studies.

Common Clinical Scenarios

Acute vision loss, trauma to the eye, or sudden onset of visual symptoms.

Billing Considerations

Rapid assessment and documentation are critical in emergency settings.

Coding Guidelines

Inclusion Criteria

Use R94.11 When
  • Follow official coding guidelines that emphasize the need for specificity in documentation and the correlation of test results with clinical findings

Exclusion Criteria

Do NOT use R94.11 When
No specific exclusions found.

Related CPT Codes

92015CPT Code

Ophthalmological examination, comprehensive, new patient

Clinical Scenario

Used when a comprehensive eye exam is performed alongside function studies.

Documentation Requirements

Document the comprehensive nature of the exam and any function studies performed.

Specialty Considerations

Ensure that all findings from the exam are clearly documented to support the use of R94.11.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of abnormal function studies, improving the granularity of data for clinical and billing purposes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of abnormal function studies, improving the granularity of data for clinical and billing purposes.

Reimbursement & Billing Impact

billing purposes.

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 types of function studies are included under R94.11?

R94.11 encompasses various ocular function studies, including visual acuity tests, color vision assessments, and contrast sensitivity tests, among others.