ICD-10 Coding for Choroidal Neovascularization(H35.3211, H44.2A1)
Complete ICD-10-CM coding and documentation guide for Choroidal Neovascularization. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Choroidal Neovascularization
H35.32Primary Range
Exudative age-related macular degeneration
Primary range for CNV related to age-related macular degeneration.
Degenerative myopia with choroidal neovascularization
Used for CNV secondary to degenerative myopia.
Choroidal neovascularization secondary to chorioretinitis
Used for CNV secondary to inflammatory conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H35.3211 | Exudative age-related macular degeneration, right eye, active | Use when CNV is active in the right eye due to AMD. |
|
| H44.2A1 | Degenerative myopia with choroidal neovascularization, right eye | Use when CNV is secondary to degenerative myopia. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for choroidal neovascularization
Essential facts and insights about Choroidal Neovascularization
Primary ICD-10-CM Codes for choroidal neovascularization
Decision Criteria
clinical Criteria
- Active leakage on OCT-A
coding Criteria
- Correct laterality and activity status
Applicable To
- Active CNV in AMD
Excludes
- CNV due to myopia
- CNV due to inflammation
Clinical Validation Requirements
- OCT-A showing active leakage
- FA with late leakage
Code-Specific Risks
- Incorrect laterality
- Missing 7th character for activity
Coding Notes
- Ensure correct laterality and activity status are documented.
H44.2A1 - Degenerative myopia with choroidal neovascularization, right eye
Use when CNV is secondary to degenerative myopia.
Applicable To
- CNV due to myopia
Excludes
- CNV due to AMD
- CNV due to inflammation
Clinical Validation Requirements
- Axial length >26.5mm
- Presence of lacquer cracks
Coding Notes
Ensure documentation supports myopic etiology.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term use of anti-VEGF
Z79.82Differential 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 Choroidal Neovascularization to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H35.3211.
Impact
Clinical: Impacts treatment decisions., Regulatory: Leads to coding inaccuracies., Financial: Potential claim denials.
Mitigation Strategy
Always document imaging findings., Use templates to ensure completeness.
Impact
Reimbursement: Claims may be denied or delayed., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate patient records.
Mitigation Strategy
Verify and document the correct eye affected by CNV.
Impact
Claims with incorrect laterality are frequently audited.
Mitigation Strategy
Double-check documentation and coding for 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 Choroidal Neovascularization, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Choroidal Neovascularization
Use these documentation templates to ensure complete and accurate documentation for Choroidal Neovascularization. These templates include all required elements for proper coding and billing.
Active CNV in AMD
Specialty: OphthalmologyRequired Elements
- Laterality
- CNV activity status
- Imaging evidence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Choroidal Neovascularization? Ask your questions below.