ICD-10 Coding for Poor Vision(H54.0, H54.2)
Complete ICD-10-CM coding and documentation guide for Poor Vision. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Poor Vision
H54.0-H54.7Primary Range
Blindness and low vision
This range covers various degrees of visual impairment, including blindness and low vision, which are critical for coding poor vision.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H54.0 | Blindness, both eyes | Use when both eyes are completely blind. |
|
| H54.2 | Low vision, both eyes | Use when both eyes have reduced vision but are not blind. |
|
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 poor vision
Essential facts and insights about Poor Vision
Primary ICD-10-CM Codes for poor vision
Decision Criteria
clinical Criteria
- Both eyes must meet criteria for blindness.
Applicable To
- Complete loss of vision in both eyes
Excludes
- Blindness in one eye with low vision in other eye (H54.1)
Clinical Validation Requirements
- Visual acuity of 20/200 or worse in both eyes
- Visual field of less than 20 degrees in both eyes
Code-Specific Risks
- Ensure documentation specifies blindness in both eyes to avoid incorrect coding.
Coding Notes
- Ensure laterality and severity are documented.
H54.2 - Low vision, both eyes
Use when both eyes have reduced vision but are not blind.
Applicable To
- Reduced vision in both eyes
Excludes
- Blindness in one eye with low vision in other eye (H54.1)
Clinical Validation Requirements
- Visual acuity worse than 20/70 but better than 20/200 in both eyes
Coding Notes
Ensure laterality and severity are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unqualified visual loss, one eye
H54.6Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Blindness, one eye, low vision other eye
H54.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Poor Vision to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H54.0.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims.
Mitigation Strategy
Always include the underlying cause of vision loss., Use templates to ensure completeness.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Could result in non-compliance with coding standards., Data Quality: Affects the accuracy of patient records.
Mitigation Strategy
Always specify laterality when documented.
Impact
Using unspecified codes when laterality is documented.
Mitigation Strategy
Always code the specific eye affected.
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 Poor Vision, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Poor Vision
Use these documentation templates to ensure complete and accurate documentation for Poor Vision. These templates include all required elements for proper coding and billing.
Documenting visual impairment in an ophthalmology clinic
Specialty: OphthalmologyRequired Elements
- Visual acuity measurements
- Visual field testing results
- Etiology of vision loss
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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