ICD-10 Coding for Vision Impairment(H54.0, H54.1)
Complete ICD-10-CM coding and documentation guide for Vision Impairment. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Vision Impairment
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 meet the criteria for legal blindness. |
|
| H54.1 | Blindness, one eye, low vision other eye | Use when one eye is blind and the other has low vision. |
|
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 vision impairment
Essential facts and insights about Vision Impairment
Primary ICD-10-CM Codes for vision impairment
Decision Criteria
clinical Criteria
- Both eyes must have visual acuity of 20/200 or worse.
Applicable To
- Legal blindness 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 20 degrees or less
Code-Specific Risks
- Ensure documentation specifies both eyes are affected.
Coding Notes
- Ensure to code the underlying cause of blindness first.
H54.1 - Blindness, one eye, low vision other eye
Use when one eye is blind and the other has low vision.
Applicable To
- Blindness in one eye with low vision in the other
Excludes
- Blindness in both eyes (H54.0)
Clinical Validation Requirements
- One eye with visual acuity of 20/200 or worse
- Other eye with visual acuity better than 20/200 but worse than 20/70
Coding Notes
Ensure to code the underlying cause of blindness first.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified visual disturbances
H53.8Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Vision Impairment to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H54.0.
Impact
Clinical: Inaccurate patient records., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document the underlying condition., Use templates to ensure completeness.
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces accuracy of health records.
Mitigation Strategy
Query for specific details such as laterality and category of impairment.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Ensure detailed documentation and use of specific codes.
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 Vision Impairment, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Vision Impairment
Use these documentation templates to ensure complete and accurate documentation for Vision Impairment. These templates include all required elements for proper coding and billing.
Ophthalmology Progress Note
Specialty: OphthalmologyRequired Elements
- Visual Acuity
- Visual Fields
- Etiology
- Impairment Category
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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