ICD-10 Coding for High Myopia(H44.21, H52.13)
Complete ICD-10-CM coding and documentation guide for High Myopia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to High Myopia
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H44.21 | Degenerative myopia, right eye | Use when degenerative changes are present in the right eye. |
|
| H52.13 | Myopia, bilateral | Use for high myopia without degenerative changes. |
|
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 high myopia
Essential facts and insights about High Myopia
Primary ICD-10-CM Codes for high myopia
Decision Criteria
clinical Criteria
- Presence of axial length >32.5 mm and posterior staphyloma
Applicable To
- Axial length >32.5 mm
- Posterior staphyloma
Excludes
Clinical Validation Requirements
- Axial length >32.5 mm
- Fundus abnormalities such as staphyloma
Code-Specific Risks
- Incorrect use without axial length documentation
Coding Notes
- Ensure axial length and fundus findings are documented.
H52.13 - Myopia, bilateral
Use for high myopia without degenerative changes.
Applicable To
- Myopia ≤−6.00 D
Excludes
- Degenerative myopia
Clinical Validation Requirements
- Refractive error ≤−6.00 D
- No degenerative changes
Coding Notes
Ensure refractive error is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Retinal detachment
H44.5Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting High Myopia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H44.21.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure biometry is performed for all high myopia cases, Train staff on documentation standards
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use H44.2x for degenerative myopia.
Impact
Lack of axial length documentation can lead to audit issues.
Mitigation Strategy
Implement mandatory documentation checks for axial length in high myopia cases.
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 High Myopia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for High Myopia
Use these documentation templates to ensure complete and accurate documentation for High Myopia. These templates include all required elements for proper coding and billing.
Progressive high myopia with degenerative changes
Specialty: OphthalmologyRequired Elements
- Visual acuity
- Refractive error
- Axial length
- Fundus findings
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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