ICD-10 Coding for Nystagmus(H55.0, H55.81)
Complete ICD-10-CM coding and documentation guide for Nystagmus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Nystagmus
H55Primary Range
Nystagmus and other irregular eye movements
This range includes all types of nystagmus and related irregular eye movements.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H55.0 | Nystagmus | Use when nystagmus is present without further specification. |
|
| H55.81 | Gaze-evoked nystagmus | Use when nystagmus is induced by lateral gaze. |
|
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 nystagmus
Essential facts and insights about Nystagmus
Primary ICD-10-CM Codes for nystagmus
Decision Criteria
clinical Criteria
- Presence of involuntary eye movements
Applicable To
- Congenital nystagmus
- Acquired nystagmus
Clinical Validation Requirements
- Documented involuntary eye movements
- Direction and characteristics of nystagmus
Code-Specific Risks
- Risk of using unspecified code when more specific details are available.
Coding Notes
- Ensure documentation includes specific characteristics of nystagmus.
H55.81 - Gaze-evoked nystagmus
Use when nystagmus is induced by lateral gaze.
Applicable To
- Nystagmus induced by lateral gaze
Excludes
- Congenital nystagmus (H55.03)
- Latent nystagmus (H55.82)
Clinical Validation Requirements
- Nystagmus present only in lateral gaze
- Resolves with central fixation
Coding Notes
Document the specific gaze that induces nystagmus.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Positional nystagmus test
92542Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Nystagmus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H55.0.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use detailed templates for documentation, Regular training on documentation standards
Impact
Reimbursement: Potential denial of claims due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation includes all specific characteristics to use the most accurate code.
Impact
Audits may focus on the specificity of documented nystagmus characteristics.
Mitigation Strategy
Use detailed templates and ensure comprehensive documentation.
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 Nystagmus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Nystagmus
Use these documentation templates to ensure complete and accurate documentation for Nystagmus. These templates include all required elements for proper coding and billing.
Neurology evaluation of nystagmus
Specialty: NeurologyRequired Elements
- Direction and type of nystagmus
- Triggers and modifying factors
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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