ICD-10 Coding for Watery Eye(H04.21, H04.22)
Complete ICD-10-CM coding and documentation guide for Watery Eye. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Watery Eye
H04.2Primary Range
Disorders of lacrimal system
This range includes codes for epiphora, specifying causes such as excessive tear production or drainage obstruction.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H04.21 | Epiphora due to excessive lacrimation | Use when excessive tear production is the primary cause of watery eyes. |
|
| H04.22 | Epiphora due to insufficient drainage | Use when drainage obstruction is the primary cause of watery eyes. |
|
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 watery eyes
Essential facts and insights about Watery Eye
Primary ICD-10-CM Codes for watery eye
Decision Criteria
clinical Criteria
- Excessive tearing with normal drainage tests
Applicable To
- Excessive tearing due to irritants
- Reflex tearing
Excludes
- Epiphora due to insufficient drainage (H04.22)
Clinical Validation Requirements
- Schirmer’s test >15mm
- Negative lacrimal irrigation
Code-Specific Risks
- Risk of using unspecified codes if laterality is not documented.
Coding Notes
- Ensure documentation specifies the cause of tearing and laterality.
H04.22 - Epiphora due to insufficient drainage
Use when drainage obstruction is the primary cause of watery eyes.
Applicable To
- Blocked nasolacrimal duct
Excludes
- Epiphora due to excessive lacrimation (H04.21)
Clinical Validation Requirements
- Dye disappearance test >5 minutes
- Lacrimal irrigation shows obstruction
Coding Notes
Document the specific cause of obstruction and confirm with diagnostic tests.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Watery Eye to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H04.21.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Increases audit risk., Financial: May result in claim denials.
Mitigation Strategy
Use structured templates., Train staff on documentation requirements.
Impact
Reimbursement: Unspecified codes may lead to claim denials., Compliance: Increases audit risk due to lack of specificity., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Always document and code the specific laterality (e.g., H04.201 for right eye).
Impact
Using unspecified codes increases audit risk.
Mitigation Strategy
Ensure documentation includes specific laterality and cause.
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 Watery Eye, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Watery Eye
Use these documentation templates to ensure complete and accurate documentation for Watery Eye. These templates include all required elements for proper coding and billing.
Epiphora due to drainage obstruction
Specialty: OphthalmologyRequired Elements
- Patient history
- Diagnostic test results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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