Oct 01, 2021 · Age-related nuclear cataract, bilateral. H25.13 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM H25.13 became effective on October 1, 2021.
Oct 01, 2021 · 2022 ICD-10-CM Diagnosis Code H25.1 2022 ICD-10-CM Diagnosis Code H25.1 Age-related nuclear cataract 2016 2017 2018 2019 2020 2021 2022 Non-Billable/Non-Specific Code H25.1 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
When submitting CPT code 66821, you can use these codes to indicate medical necessity: H26.491 Other secondary cataract, right eye . H26.492 Other secondary cataract, left eye . H26.493 Other secondary cataract, bilateral
ICD-10-CM Code H25.13 Age-related nuclear cataract, bilateral BILLABLE Adult Only | ICD-10 from 2011 - 2016 H25.13 is a billable ICD code used to specify a diagnosis of age-related nuclear cataract, bilateral. A 'billable code' is detailed enough to be used to specify a medical diagnosis. The ICD code H25 is used to code Cataract
How many different types of cataracts are there? According to ICD-10-CM, there are close to 70 — ranging from age-related to zonular cataracts.
When you submit CPT code 66982, local coverage determinations (LCDs) require more than the traditional cataract diagnosis codes. To indicate why the surgery qualifies as complex, you also must report one of the following codes:
Code is only used for patients 15 years old or older. H25.13 is a billable ICD code used to specify a diagnosis of age-related nuclear cataract, bilateral.
This means that while there is no exact mapping between this ICD10 code H25.13 and a single ICD9 code, 366.16 is an approximate match for comparison and conversion purposes.
When one or more concomitant ocular diseases are present that potentially affect visual function (e.g., macular degeneration or diabetic retinopathy), the attestation should indicate that cataract is believed to be significantly contributing to the patient’s visual impairment.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service . Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.
An appropriate preoperative ophthalmologic evaluation, which generally includes a comprehensive ophthalmologic exam (or its equivalent components occurring over a series of visits). Certain examination components may be appropriately excluded based on the specific condition and/or urgency of surgical intervention.
A statement that the patient desires surgical correction, that the risks, benefits, and alternatives have been explained, and that a reasonable expectation exists that lens surgery will significantly improve both the visual and functional status of the patient.
Every complex cataract surgery must have a justification to meet the requirements of its CPT descriptor. Therefore, it is strongly recommended to include an initial supporting statement in the operative note. For example:
For example, the presence of "pseudoexfoliation syndrome," which is known to predispose to weaker lens zonules and thus to an increased risk for loss of capsular support for an intraocular lens, would not be sufficient if the zonular support ended up being adequate and no special tools or techniques were employed during surgery. Similarly, a particularly dense cataract that required extra surgical time to address would not qualify.
Billing and Coding articles provide guidance for the related Local Coverage Determination (LCD) and assist providers in submitting correct claims for payment. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. The code lists in the article help explain which services (procedures) the related LCD applies to, the diagnosis codes for which the service is covered, or for which the service is not considered reasonable and necessary and therefore not covered.
H25.89* may be used if the operative note indicates dye was used to stain the anterior capsule.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service . Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.
The use of an ICD-10-CM codes listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in the related LCD.