ICD-10 Coding for Lattice Degeneration(H35.41, H35.411, H35.412)
Complete ICD-10-CM coding and documentation guide for Lattice Degeneration. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lattice Degeneration
H35.4Primary Range
Other Retinal Disorders
This range includes specific codes for retinal degenerations, including lattice degeneration.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H35.41 | Lattice degeneration of retina | Use when lattice degeneration is diagnosed without specifying laterality. |
|
| H35.411 | Lattice degeneration of retina, right eye | Use when lattice degeneration is diagnosed in the right eye. |
|
| H35.412 | Lattice degeneration of retina, left eye | Use when lattice degeneration is diagnosed in the left eye. |
|
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 lattice degeneration
Essential facts and insights about Lattice Degeneration
Primary ICD-10-CM Codes for lattice degeneration
Decision Criteria
clinical Criteria
- Presence of lattice degeneration on OCT without laterality specified.
Applicable To
- Lattice degeneration without specification of laterality
Excludes
- Retinal detachment (H33.0)
Clinical Validation Requirements
- OCT findings showing retinal thinning
- Vitreous adhesion at lesion margins
Code-Specific Risks
- Risk of unspecified laterality leading to incorrect billing.
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
H35.411 - Lattice degeneration of retina, right eye
Use when lattice degeneration is diagnosed in the right eye.
Applicable To
- Lattice degeneration affecting the right eye
Excludes
- Retinal detachment (H33.0)
Clinical Validation Requirements
- OCT findings showing retinal thinning in the right eye
- Vitreous adhesion at lesion margins in the right eye
Coding Notes
Ensure right eye laterality is documented.
H35.412 - Lattice degeneration of retina, left eye
Use when lattice degeneration is diagnosed in the left eye.
Applicable To
- Lattice degeneration affecting the left eye
Excludes
- Retinal detachment (H33.0)
Clinical Validation Requirements
- OCT findings showing retinal thinning in the left eye
- Vitreous adhesion at lesion margins in the left eye
Coding Notes
Ensure left eye laterality is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Degenerative myopia
H44.2Differential 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 Lattice Degeneration to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H35.41.
Impact
Clinical: Inaccurate patient records., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify the affected eye in documentation.
Impact
Reimbursement: Incorrect laterality can lead to claim denials., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Reduces accuracy of patient records.
Mitigation Strategy
Always document and code the specific eye affected (right or left).
Impact
Failure to document laterality can lead to audit issues.
Mitigation Strategy
Implement a checklist to ensure laterality is documented.
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 Lattice Degeneration, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lattice Degeneration
Use these documentation templates to ensure complete and accurate documentation for Lattice Degeneration. These templates include all required elements for proper coding and billing.
Lattice degeneration diagnosis
Specialty: OphthalmologyRequired Elements
- Laterality
- OCT findings
- Vitreous adhesion
- Choroidal thickness
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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