ICD-10 Coding for Optic Neuropathy(H47.011, H46.2)
Complete ICD-10-CM coding and documentation guide for Optic Neuropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Optic Neuropathy
H47.01-H47.09Primary Range
Ischemic Optic Neuropathy
This range covers ischemic optic neuropathy, which is a primary condition under optic neuropathy.
Optic Neuritis
This range includes optic neuritis, which can be a differential diagnosis for optic neuropathy.
Nutritional Optic Neuropathy
This code is used for cases of optic neuropathy due to nutritional deficiencies.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H47.011 | Ischemic optic neuropathy, right eye | Use when there is sudden vision loss with optic disc pallor and no evidence of arteritis. |
|
| H46.2 | Nutritional optic neuropathy | Use when optic neuropathy is due to nutritional deficiencies confirmed by lab tests. |
|
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 ischemic optic neuropathy
Essential facts and insights about Optic Neuropathy
Primary ICD-10-CM Codes for optic neuropathy
Decision Criteria
clinical Criteria
- Sudden, painless vision loss with optic disc pallor
documentation Criteria
- Document laterality and exclude arteritis
Applicable To
- Non-arteritic ischemic optic neuropathy
Clinical Validation Requirements
- OCT showing retinal nerve fiber layer thinning
- VEP showing delayed latency
- CRP < 10 mg/L (non-arteritic)
Code-Specific Risks
- Mislaterality documentation
- Lack of objective test results
Coding Notes
- Ensure laterality is documented and validated with clinical tests.
H46.2 - Nutritional optic neuropathy
Use when optic neuropathy is due to nutritional deficiencies confirmed by lab tests.
Applicable To
- Optic neuropathy due to B12 deficiency
Excludes
- Ischemic optic neuropathy (H47.01-)
- Toxic optic neuropathy (H46.3)
Clinical Validation Requirements
- Serum B12 level < 200 pg/mL
- Bilateral central scotomas
Coding Notes
Ensure nutritional deficiency is confirmed with lab results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Neuromyelitis optica
G36.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Optic Neuropathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H47.011.
Impact
Clinical: Misdiagnosis risk, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Use templates for documentation, Regular training on coding updates
Impact
Reimbursement: Incorrect laterality can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure laterality is clearly documented and coded.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Potential for audit flags., Data Quality: Compromised data accuracy.
Mitigation Strategy
Use specific codes like H47.011 for ischemic cases instead of general codes.
Impact
Failure to document laterality can lead to audit flags.
Mitigation Strategy
Implement mandatory fields in EHR 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 Optic Neuropathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Optic Neuropathy
Use these documentation templates to ensure complete and accurate documentation for Optic Neuropathy. These templates include all required elements for proper coding and billing.
Neuro-ophthalmology evaluation
Specialty: OphthalmologyRequired Elements
- History of vision loss
- Fundoscopic exam findings
- Objective test results
- Exclusion of differentials
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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