Icd 10 code for bacterial conjunctivitis

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Icd 10 code for bacterial conjunctivitis

Acute conjunctivitis, unspecifiedApproximate SynonymsAcute conjunctivitisAcute conjunctivitis, both eyesBilat acute conjunctivitisBilateral acute conjunctivitisConjunctivitis, acuteL acute conjunctivitisLeft acute conjunctivitisLeft acute conjunctivitis (eye condition)R acute conjunctivitisRight acute conjunctivitisRight acute conjunctivitis (eye condition)ICD-9-CM Volume 2 Index entries containing back-references to 372.00:Abscess (acute) (chronic) (infectional) (lymphangitic) (metastatic) (multiple) (pyogenic) (septic) (with lymphangitis) (see also Cellulitis) 682.9conjunctiva 372.00Caruncle (inflamed)conjunctiva 372.00acute 372.00Conjunctivitis (exposure) (infectious) (nondiphtheritic) (pneumococcal) (pustular) (staphylococcal) (streptococcal) NEC 372.30Ulcer, ulcerated, ulcerating, ulceration, ulcerative 707.9conjunctiva (acute) (postinfectional) 372.00 Conjunctivitis, unspecified2015Billable Thru Sept 30/2015Non-Billable On/After Oct 1/2015Approximate SynonymsBacterial conjunctivitisBilat conjunctivitisBilat infectious conjunctivitisbilateral conjunctivitisbilateral infectious conjunctivitisBurn of pharynxConjunctivitisInfectious conjunctivitisInfective conjunctivitisLeft conjunctivitisLeft infectious conjunctivitisRight conjunctivitisRight infectious conjunctivitisClinical InformationConjunctivitis; inflammation of the conjunctiva of the eyeInflammation of the mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera; also called pinkeye and redeyeICD-9-CM Volume 2 Index entries containing back-references to 372.30: Examples: ICD M32, ICD R6521, ICD 8210, ICD 1970 ICD Code Description H1030 Unspecified acute conjunctivitis, unspecified eye H1031 Unspecified acute conjunctivitis, right eye H1032 Unspecified acute conjunctivitis, left eye H1033 Unspecified acute conjunctivitis, bilateral *Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018. *Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018. ICD Code ICD Description Total National Projected Hospitalizations - Annualized (Present on Admission - All) Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - All) Total National Projected Hospitalizations - Annualized (Present on Admission - Yes) Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Yes) Total National Projected Hospitalizations - Annualized (Present on Admission - Not Y) Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Not Y) Total Medicare Hospitalization after Exclusion Avg. LOS Readmission Rate (%) Unplanned Readmission Rate (%) Total Medicare Payments Payment Per Day Payment Per Hospitalization Total Medicare Charges Avg. Charges Mortality Rate (%) SNF Discharge Rate (%) Home Discharge Rate (%) H1033 Unspecified acute conjunctivitis, bilateral 7.84 20.76 H1032 Unspecified acute conjunctivitis, left eye 8.17 22.98 H1031 Unspecified acute conjunctivitis, right eye 8.72 22.5 H1030 Unspecified acute conjunctivitis, unspecified eye 8.73 24.94 This week's post comes from National Compliance and Quality Audit Manager, Sharon Nichols, BSBEB, RHIT, CCS, CHTS-TR. It's the most wonderful time of the year! That's right, it's back to school for the kiddos. As the hustle and bustle of the new school year starts and the morning drive (flashing red, school bus ahead) slows to the pace of a horse and carriage ride, our children will soon be sharing more than summer vacation stories with their friends. As parents, teachers and school administrators deal with runny noses, sneezing and coughing (into the left elbow please) we in the healthcare industry will be tasked with applying the ever interesting and complicated codes associated with all those bugs. Bugs come in all shapes and sizes; bacteria, viruses, and yes, my friends, even bugs. Head lice, for one, is an elementary school nightmare and very hard to stamp out with so many children in close quarters. Our focus in this three-part series will be on the most common bugs our little darlings in grade school like to share the first few weeks of school. First, we'll discuss type and transmission of conjunctivitis... what a lovely pink eye you have. Then we'll discuss Rhino vs. Entero viruses...doesn't a rhino live in the zoo? And finally, when your six-year-old excitedly tells you that he has "the head lights" it doesn't mean he took them from the car, it's our favorite little creepy critter head lice. Now that your eyes are itching, you're wheezing, your tummy is upset and your skin is crawling, let's get a little more comfortable with our knowledge and coding. We won't go into the many differences between bacteria and viruses or the various bugs we studied in school, but the distinct components of Pink Eye in this first part of our series. Pink Eye The conjunctiva is the membrane lining the eyelids and covering the eyeball, irritation and infection can be referred to as `Pink eye'. Pink eye can be caused by viruses such as adenovirus, bacteria such as Staph or Strep, allergens like pollen and dust, or irritants like chemicals and contact lenses. Pink Eye is an acute form of conjunctivitis described as mucopurulent meaning there is a purulent discharge from the eye. Pink Eye falls into one of two ICD-10-CM categories from Chapter 7. Diseases of the eye and adnexa; Acute Follicular or Other Mucopurulent conjunctivitis. When it's due to a bacteria or virus specified in the Infectious Disease chapter, the code would come from that chapter instead. Mild cases of pink eye usually resolve on their own, but there are key indicators that medical treatment is necessary. When pain in the eye becomes moderate to severe and light sensitivity exists, or that cotton candy pink tone to the whites of the eye(s) turns an angry red, medical treatment is needed. So, we know what causes Pink Eye, but how do we code such a colorful condition? Coding is dependent upon the cause or source of the conjunctivitis and the laterality. Follicular conjunctivitis is determined by macroscopic or microscopic appearance of small, dome-shaped follicles without a prominent central vessel and can be seen with inflammation caused by pathogens, toxins and medications. This condition is coded in the H10.01 ? H10.02 series of codes. This should not be mistaken for Papillary conjunctivitis which shows a cobblestone appearance with a central vessel, typically caused by an allergic response or foreign object such as a contact lens. Due to exposure means keratoconjunctivitis wherein the conjunctiva and cornea are affected, this can be seen in cases where the patient is exposed to chemicals or other irritants and is coded from the H16.21 series of codes. This is not `Pink Eye' in the form caused by patient to patient transmission. Case Study ? A patient presents with pain in the left eye with itching and drainage after being around his niece who has pink eye. The physician examines the eyes and notes drainage, irritation, redness and pain without involvement of the cornea in the left eye. The right eye is clear of symptoms and the final diagnosis pink eye on the left. Pink Eye is defined as acute mucopurulent conjunctivitis, other/unspecified unless the physician indicates a specific type or cause. H10.002 Symptoms are not coded separately as they are inherent to the disease process You may browse the classification by using the hierarchy on the left or by using the search functionality More information on how to use the online browser is available in the Help 2016 2017 2018 2019 2020 2021 Billable/Specific Code H10.89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM H10.89 became effective on October 1, 2020. This is the American ICD-10-CM version of H10.89 - other international versions of ICD-10 H10.89 may differ. The following code(s) above H10.89 contain annotation back-referencesAnnotation Back-ReferencesIn this context, annotation back-references refer to codes that contain:Applicable To annotations, orCode Also annotations, orCode First annotations, orExcludes1 annotations, orExcludes2 annotations, orIncludes annotations, orNote annotations, orUse Additional annotations that may be applicable to H10.89: H00-H59 2021 ICD-10-CM Range H00-H59Diseases of the eye and adnexaNoteUse an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye conditionType 2 Excludescertain conditions originating in the perinatal period (P04-P96)certain infectious and parasitic diseases (A00-B99)complications of pregnancy, childbirth and the puerperium (O00-O9A)congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)endocrine, nutritional and metabolic diseases (E00-E88)injury (trauma) of eye and orbit (S05.-)injury, poisoning and certain other consequences of external causes (S00-T88)neoplasms (C00-D49)symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71) Diseases of the eye and adnexaH10 ICD-10-CM Diagnosis Code H102016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code Type 1 Excludeskeratoconjunctivitis (H16.2-) Conjunctivitis Approximate Synonyms Bacterial conjunctivitis Bilateral bacterial conjunctivitis Bilateral conjunctivitis w mucocutaneous disorder Bilateral infectious conjunctivitis Conjunctivitis of bilateral eyes co-occurrent and due to mucocutaneous disorder Conjunctivitis with mucocutaneous disorder Infectious conjunctivitis Infective conjunctivitis Left bacterial conjunctivitis Left infectious conjunctivitis Left parinauds conjunctivitis Left parinauds conjunctivitis (eye condition) Parinaud's syndrome Parinauds conjunctivitis Parinauds syndrome Right bacterial conjunctivitis Right infectious conjunctivitis Right parinauds conjunctivitis Right parinauds conjunctivitis (eye condition) ICD-10-CM H10.89 is grouped within Diagnostic Related Group(s) (MS-DRG v38.0): 124 Other disorders of the eye with mcc 125 Other disorders of the eye without mcc Convert H10.89 to ICD-9-CM Code History 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM) 2017 (effective 10/1/2016): No change 2018 (effective 10/1/2017): No change 2019 (effective 10/1/2018): No change 2020 (effective 10/1/2019): No change 2021 (effective 10/1/2020): No change Diagnosis Index entries containing back-references to H10.89: ICD-10-CM Codes Adjacent To H10.89 Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes. The most common codes that will be used in Primary Care are related to conjunctivitis. The two categories related to conjunctivitis are found in the table below, but the most commonly used codes are: ? H10.0 Mucopurulent conjunctivitis ? H10.01- Acute follicular conjunctivitis ? H10.02- Other mucopurulent conjunctivitis ? H10.1- Acute atopic conjunctivitis ? H10.2 Other acute conjunctivitis ? H10.21- Acute toxic conjunctivitis ? H10.22- Pseudomembranous conjunctivitis ? H10.23- Serous conjunctivitis, except viral (B30.-) ? H10.3- Unspecified acute conjunctivitis ? H10.4 Chronic conjunctivitis ? H10.40- Unspecified chronic conjunctivitis ? H10.41- Chronic giant papillary conjunctivitis ? H10.42- Simple chronic conjunctivitis ? H10.43- Chronic follicular conjunctivitis ? H10.44 Vernal conjunctivitis ? H10.45 Other chronic allergic conjunctivitis Examples: ? Conjunctivitis: H10 ? Dry Eye: H04 ? Glaucoma: H40 ? Retinal Disorders: H33, H34, H35 ? First three digits after decimal ? Position 4, or 4 & 5: One or two digits indicating the etiology, or cause, of the condition, e.g., chronic allergic (cause) for conjunctivitis (category). ? Next, one digit that gives location, i.e., which eye:right, left, or bilateral (both). o While a laterality location code is not required for every diagnosis, we will see it on most eye codes. o A few codes require location be noted by lid rather than eye. o Laterality code will be in position 5 or 6,depending upon if there are 1 or 2 digits before denoting cause. A patient who is being followed by her Ophthalmologist during the post-op of cataract surgery comes in for an additional visit because she has developed conjunctivitis. The conjunctivitis is unrelated to the cataract surgery and necessitated an additional visit over and above her regular post-op check-ups. The E/M code for the visit is billed to the insurance carrier with a -24 modifier and the diagnosis code used is 372.02 for Acute Conjunctivitis. 1. H10.012 Acute conjunctivitis: acute follicular, LEFT eye 2. H26.121 Traumatic cataract: partially resolved RIGHT eye A54.30 Gonococcal infection, eye, unspecified A54.31 Gonococcal conjunctivitis A54.32 Gonococcal iridocyclitis A54.33 Gonococcal keratitis A54.39 Gonococcal eye infection, other H10.***: Conjunctival conditions 19 H10.011 Acute follicular conjunctivitis, right eye H10.021 Other mucopurulent conjunctivitis, right eye H10.11 Acute atopic conjunctivitis, right eye H10.211 Acute toxic conjunctivitis, right eye H10.221 Pseudomembranous conjunctivitis, right eye H10.231 Serous conjunctivitis, except viral, right eye H10.31 Unspecified acute conjunctivitis, right eye H10.401 Unspecified chronic conjunctivitis, right eye H10.***: Conjunctival conditions ? Pingueculitis is an inflammed pinguecula [ H11.151]. H10.411 Chronic giant papillary conjunctivitis (GPC), right eye H10.421 Simple chronic conjunctivitis, right eye H10.431 Chronic follicular conjunctivitis, right eye H10.501 Unspecified blepharoconjunctivitis, right eye H10.511 Ligneous conjunctivitis, right eye H10.521 Angular blepharoconjunctivitis, right eye H10.531 Contact blepharoconjunctivitis, right eye H10.811 Pingueculitis, right eye Allergic conjunctivitis is uncomfortable enough on its own, and the addition of contact lenses tends to further exacerbate the problem. Most of your contact lens wearers will hate the idea of switching back to their glasses for allergy season, so consider some alternatives to making the switch from contacts to glasses. We see many patients who present to our offi ces with complaints of red eye, or "pink eye," as they like to call it. Sportscaster Bob Costas came down with a case of it during last month's 2014 Winter Olympics that made headlines worldwide. While the majority of red eye presentations are caused by various types of conjunctivitis--which is the emphasis of this discussion--it is important to fi rst rule out other possible etiologies prior to initiating treatment for conjunctivitis. The primary types of conjunctivitis are bacterial, viral, allergic and Chlamydial--with viral and allergic being the most common. A careful evaluation of the patient's symptoms and clinical signs should enable the practitioner to arrive at a proper diagnosis. It is important to fi rst determine the type of conjunctivitis present before selecting the most appropriate treatment. This depends on the practitioner's ability to accurately assess the patient's symptoms and distinguish the clinical signs. Both of these tasks can pose signifi cant challenges for the clinician. It is usually best to have the patient defi ne itching. For example, ask the patient if the sensation they feel itches like a mosquito bite. Many patients use itching as a broader term and actually may be experiencing a mild scratchiness, which would be more consistent with an infectious process or ocular surface disease, rather than allergic conjunctivitis. Another challenge is the overlap of a patient's symptoms. For example, the chemical mediators released by chronic allergic conjunctivitis may induce a superficial punctate keratitis, which becomes more symptomatic than the original itching complaint. Additionally, keep in mind that itching of the eye itself is the hallmark sign of allergic conjunctivitis. Itching of the eyelids or lid margins may stem from etiologies related to lid disease rather than allergy A thorough evaluation of the red eye needs to discern whether the redness is due to hyperemia of the superfi cial conjunctival vessels or injection of the deeper episcleral and/or scleral vessels. Conjunctival hyperemia may indicate an increased permeability of these vessels, leading to the exudative response. Conjunctivitis alone typically does not induce limbal injection. If a determination can not be made solely with slit-lamp observation, the practitioner can always instill a vasoconstrictor and look for blanching of the vessels. Conjunctival vessels will blanch completely, episcleral vessels may partially or totally blanch and scleral vessels will not blanch at all. Most conjunctivitis cases exhibit an exudative response. Findings may include serous production (i.e., tearing); mucoid, mucopurulent or purulent discharge; fi brinous material or hemorrhage. The serous response may also lead to conjunctival chemosis. Serous discharge or excessive tearing is usually seen with allergic, toxic or viral conjunctivitis, while mucopurulent and/or purulent exudate is more associated with bacterial and Chlamydial conjunctivitis. Excessive mucous can be generated in any type of conjunctivitis, depending upon the severity of the infl ammatory response and irritation to the conjunctival goblet cells. Pseudomembrane formation is due to fi brin in the exudative material; it indicates a higher degree of infl ammation. Pseudomembrane material should always be removed, as there is risk of it becoming a true conjunctival membrane. This risk is due to delayed healing of the infl amed tissue secondary to decreased extracellular fi brinolysis. Pseudomembranes are most frequently associated with epidemic keratoconjunctivitis adenoviral disease, but can also be seen with certain bacterial conjunctivitis, such as streptococcal pneumonia or Gonococcus infection. The presence of pseudomembranes always indicates a need for topical steroids as part of the treatment plan. Conjunctival hemorrhages can be seen with any infectious etiology Tissue findings in conjunctivitis can manifest as either a papillary or follicular response. Papillae, typically seen in bacterial infection as a response to chronic irritation or allergy, are raised tissue masses found on the palpebral conjunctiva with a central vessel and are created by a focal infi ltration of infl ammatory cells. The type of infl ammatory cell depends on the underlying etiology--for example, eosinophils in allergic conditions vs. neutrophils in bacterial disease. Follicles represent expansions of the lymph system with a blisterlike appearance and a central avascular zone with the conjunctival vasculature otherwise following its normal course over the follicle. Follicles are seen in viral, Chlamydial and toxic conditions. In viral conjunctivitis, follicles form in response to viral particles having entered the lymph system, which also creates the localized preauricular lymph node response. The clinical evaluation of conjunctivitis should also include an assessment of the eyelids, cornea and relevant lymph nodes. Eyelid edema can be seen with any type of conjunctivitis, depending on the severity of the infl ammatory response. While most presentations of conjunctivitis do not affect the cornea, a careful corneal assessment should be performed to rule out any associated punctate keratopathy, dendrites or corneal infi ltrates. Their presence may illuminate a more precise diagnosis or help to better explain patient symptoms. For example, an associated punctate keratopathy may explain the patient's complaints of a gritty or scratchy feeling. The preauricular and submaxillary lymph nodes should always be palpated to rule out enlargement and/or tenderness during a workup for conjunctivitis. Both fi ndings can be associated with viral or Chlamydia infection. Other cases where laboratory diagnostic testing may be of higher value include suspected MRSA or MRSE infection, chronic conjunctivitis unresponsive to treatment, conjunctivitis potentially secondary to canaliculitis or dacryocystitis, and hyperacute conjunctivitis if Gonococcus is the suspected organism. Minitipped bacterial culturettes are very useful for collecting sample material for laboratory evaluation in these cases. Most patients report hyperemia, which may be localized, with irritation and stickiness of one eye followed by bilateral involvement in two to three days. Bacterial conjunctivitis frequently presents nasally initially, and then involves the remaining conjunctival surface. A mucopurulent or purulent discharge usually appears within the fi rst 24 hours, which may lead to some patients reporting that the eyelids are matted shut upon awakening in the morning. The sensation of eyelid stickiness or matting is more common in chronic or severe cases. ? Treatment. Topical antibiotics are the mainstay of bacterial conjunctivitis treatment. Many recent and older antibiotic agents are effective for the treatment of bacterial conjunctivitis. This is important to understand in today's world of managed care, where formulary restrictions may make it diffi cult or limit the ability to treat with many of the later generation fl uoroquinolone or macrolide agents. Proper adjunctive treatment of the eyelids is also important in chronic bacterial or lid diseaserelated conjunctivitis. Daily lid hygiene/scrubs should be part of the management plan in these cases and continue on a maintenance basis long term. Lid scrubs with a commercially prepared eyelid cleansing foam or pad product are preferred over baby shampoo for this procedure. Adjunctive treatment with a broad-spectrum oral penicillin or cephalosporin antibiotic, such as amoxicillin/ clavulanate potassium, may be indicated in hyperacute conjunctivitis, chronic conjunctivitis related to lid disease or if associated preseptal cellulitis is suspected. For Neisseria gonorrhoeae-related hyperacute conjunctivitis, one gram of ceftriaxone by IM injection is required. Proper adjunctive treatment of the eyelids is also important in chronic bacterial or lid diseaserelated conjunctivitis. Daily lid hygiene/scrubs should be part of the management plan in these cases and continue on a maintenance basis long term. Lid scrubs with a commercially prepared eyelid cleansing foam or pad product are preferred over baby shampoo for this procedure. Adjunctive treatment with a broad-spectrum oral penicillin or cephalosporin antibiotic, such as amoxicillin/ clavulanate potassium, may be indicated in hyperacute conjunctivitis, chronic conjunctivitis related to lid disease or if associated preseptal cellulitis is suspected. For Neisseria gonorrhoeae-related hyperacute conjunctivitis, one gram of ceftriaxone by IM injection is required. EYE H10.30 Acute Conjunctivitis, Unspecified H10.429 Chronic Conjunctivitis, Simple H10.44 Vernal Conjunctivitis H10.45 Other Chronic Allergic Conjunctivitis H10.501 Blepharoconjunctivitis, Unspecified, Right Eye H10.502 Blepharoconjunctivitis, Unspecified, Left Eye H10.503 Blepharoconjunctivitis, Unspecified, Bilateral H10.509 Blepharoconjunctivitis, Unspecified EAR H60.391 Infective Otitis Externa, Right Ear H60.392 Infective Otitis Externa, Left Ear H60.393 Infective Otitis Externa, Unspecified Ear H60.399 Infective Otitis Externa, Unspecified Ear H65.00 Acute Serous Otitis Media, Unspecified Ear H65.01 Acute Serous Otitis Media, Right Ear H65.02 Acute Serous Otitis Media, Left Ear H65.03 Acute Serous Otitis Media, Bilateral H65.119 Acute Allergic Serous Otitis Media H65.20 Chronic Serous Otitis Media H65.21 Chronic Serous Otitis Media, Right Ear H65.22 Chronic Serous Otitis Media, Left Ear H65.23 Chronic Serous Otitis Media, Bilateral H65.90 Other and Unspecified Chronic Nonsuppurative Otitis Media.

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