ICD-10 Coding for Age-Related Nuclear Cataract, Bilateral(H25.13)
Complete ICD-10-CM coding and documentation guide for Age-Related Nuclear Cataract, Bilateral. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Age-Related Nuclear Cataract, Bilateral
Key Information: ICD-10 code for bilateral age-related nuclear cataract
Essential facts and insights about Age-Related Nuclear Cataract, Bilateral
Primary ICD-10-CM Code for age related nuclear cataract bilateral
Decision Criteria
clinical Criteria
- Patient presents with bilateral nuclear sclerosis confirmed by slit-lamp exam.
coding Criteria
- Both eyes are affected and age-related etiology is documented.
documentation Criteria
- Documentation must specify 'bilateral' and 'nuclear' type.
Applicable To
- Bilateral nuclear sclerosis
- Bilateral brunescent cataract
Excludes
- Capsular glaucoma with pseudoexfoliation (H40.1)
Clinical Validation Requirements
- Slit-lamp examination showing nuclear sclerosis
- Visual acuity tests showing impairment
- Patient age typically over 50
Code-Specific Risks
- Incorrectly using unilateral codes when bilateral is appropriate
- Using unspecified codes when specific laterality is documented
Coding Notes
- Ensure documentation specifies 'age-related' and 'bilateral' to avoid denials.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Age-Related Nuclear Cataract, Bilateral to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H25.13.
Impact
Clinical: Inaccurate patient records., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Use templates that prompt for laterality, Regular training on documentation standards
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Always use H25.13 for bilateral cases when specified.
Impact
Missing laterality in documentation can lead to audit flags.
Mitigation Strategy
Ensure all documentation specifies laterality.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Age-Related Nuclear Cataract, Bilateral, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Age-Related Nuclear Cataract, Bilateral
Use these documentation templates to ensure complete and accurate documentation for Age-Related Nuclear Cataract, Bilateral. These templates include all required elements for proper coding and billing.
Routine Eye Exam
Specialty: OphthalmologyRequired Elements
- Chief complaint
- Visual acuity
- Slit-lamp findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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