ICD-10 Coding for Bilateral Age-Related Combined Form Cataract(H25.813)
Complete ICD-10-CM coding and documentation guide for Bilateral Age-Related Combined Form Cataract. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bilateral Age-Related Combined Form Cataract
H25.81-H25.89Primary Range
Age-related cataract
This range includes codes for various forms of age-related cataracts, including combined forms.
Key Information: ICD-10 code for bilateral age-related combined form cataract
Essential facts and insights about Bilateral Age-Related Combined Form Cataract
Primary ICD-10-CM Code for bilat age related combined form cataract
Decision Criteria
clinical Criteria
- Presence of nuclear and cortical cataracts in both eyes
documentation Criteria
- Explicit mention of 'age-related' and 'combined forms'
Applicable To
- Bilateral nuclear and cortical cataracts
- Bilateral mixed cataracts
Excludes
- Traumatic cataract
- Congenital cataract
Clinical Validation Requirements
- Slit-lamp examination confirming nuclear and cortical opacities
- Patient age between 15-124 years
- Documentation of 'age-related' etiology
Code-Specific Risks
- Incorrectly coding as H25.2 for hypermature cataracts
- Failing to specify 'age-related' in documentation
Coding Notes
- Ensure documentation specifies 'combined forms' and lists specific types of cataracts.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Type 2 diabetes mellitus with other diabetic ophthalmic complication
E11.39Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Bilateral Age-Related Combined Form Cataract to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H25.813.
Impact
Clinical: Misclassification of cataract etiology., Regulatory: Potential audit findings for non-compliance., Financial: Claim denials due to incorrect coding.
Mitigation Strategy
Always include 'age-related' in documentation for elderly patients., Educate staff on documentation requirements.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate data on cataract prevalence and treatment.
Mitigation Strategy
Reserve H25.2 for hypermature cataracts only.
Impact
Lack of detail in cataract type and etiology documentation.
Mitigation Strategy
Implement detailed documentation templates and regular audits.
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 Bilateral Age-Related Combined Form Cataract, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bilateral Age-Related Combined Form Cataract
Use these documentation templates to ensure complete and accurate documentation for Bilateral Age-Related Combined Form Cataract. These templates include all required elements for proper coding and billing.
Bilateral age-related cataracts with nuclear and cortical opacities
Specialty: OphthalmologyRequired Elements
- Patient age
- Cataract types (nuclear, cortical)
- Laterality (bilateral)
- Age-related etiology
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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