icd 10 code for uveitis-glaucoma-hyphema syndrome

Full Answer

How do you code uveitis glaucoma hyphema (Ugh) syndrome?

Question: How do we code for uveitis, glaucoma, hyphema (UGH) syndrome? Answer: Gordon Johns, MD, recommends either H59.89 Other postprocedural complications and disorders of eye and adnexa, NEC or T85.698 Other mechanical complication of other specified internal prosthetic devices, implants and grafts.

What is the ICD 10 code for glaucoma?

H40.42X0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Glaucoma secondary to eye inflammation, left eye, stage unsp

What is the ICD 10 code for uveitis?

Initial diagnosis: Primary chronic anterior uveitis, OU. ICD-10 code: H20.13 The patient’s laboratory work was unremarkable except for a positive QuantiFERON-TB Gold test and a chest x-ray demonstrating multiple focal granulomatous scars. HLA-B27 and RPR/FTA were both negative.

What is the difference between uveitis and hyphema?

UGH syndrome results from an IOL chafing the iris, iridocorneal angle, or ciliary body, which leads to recurrent trauma to these structures. Uveitis results from mechanical breakdown of the blood aqueous barrier and resultant inflammation. A hyphema results from recurrent damage by the IOL to vascular tissue of the iris, ciliary body, or angle.

What is uveitis Glaucoma hyphema syndrome?

Disease. Uveitis-Glaucoma-Hyphema (UGH) Syndrome or Ellingson syndrome is a complication of intraocular chafing from intraocular lens (IOL) implants leading to a spectrum of iris transillumination defects and pigmentary dispersion to microhyphemas and hyphemas with elevated intraocular pressure (IOP).

What is the ICD 10 code for uveitis?

ICD-10 codes: H43. 89, h45.

What is ICD 10 code for eye problem?

H57. 9 - Unspecified disorder of eye and adnexa. ICD-10-CM.

What is the ICD 10 code for traumatic iritis?

049.

What is the ICD 10 code for glaucoma?

H40. 9 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 H40.

What is uveitis of the eyes?

Uveitis is inflammation of the middle layer of the eye, called the uvea or uveal tract. It can cause eye pain and changes to your vision. Most cases get better with treatment – usually steroid medicine. But sometimes uveitis can lead to further eye problems such as glaucoma and cataracts.

What is ICD-10 code R51?

ICD-10 code R51 for Headache is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .

What are visual disturbances?

Visual disturbance is when you experience a short spell of flashing or shimmering of light in your sight. The symptoms normally last around twenty minutes before your sight returns to normal.

What is the ICD-10 code for bulging eyes?

Edema of eyelid ICD-10-CM H02. 843 is grouped within Diagnostic Related Group(s) (MS-DRG v39.0): 124 Other disorders of the eye with mcc.

Is uveitis the same as iritis?

Iritis is the most common type of uveitis. Uveitis is inflammation of part of or all of the uvea. The cause is often unknown. It can result from an underlying condition or genetic factor.

What is traumatic uveitis?

Traumatic iritis is inflammation of the iris due to trauma.

What is the ICD 10 code for anterior uveitis left eye?

H20. 012 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 H20.

What is the ICD 10 code for anterior uveitis left eye?

H20. 012 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 H20.

What is acute anterior uveitis?

Acute anterior uveitis is characterised by an extremely painful red eye, often associated with photophobia, and occasionally with decreased visual acuity. Chronic anterior uveitis is defined as inflammation lasting over 6 weeks. It is usually asymptomatic, but many people have mild symptoms during exacerbations.

What is the ICD 9 code for uveitis?

The ICD-9 diagnosis code 364.04 (secondary noninfectious iridocyclitis) contributed the most confirmed uveitis cases (30.8% [69 of 224]).

What is chronic uveitis?

Chronic uveitis is defined as uveitis lasting longer than six weeks. Posterior Uveitis is inflammation of the choroid, often involving the retina and optic nerve. and optic nerve. It is also known as choroiditis or retinitis. The optic nerve is the path that carries images from the retina to the brain.

What is the least appropriate code for uveitis?

The least appropriate code is unspecified. Only use unspecified when there is not a more definitive code. Reviewing the principles of ICD-10 and the classifications of uveitis will help ensure correct ...

What is the diagnosis of anterior uveitis?

The process of diagnosing anterior uveitis and determining the most specific code is outlined in Figure 1. The initial diagnosis of anterior uveitis (primary acute, recurrent acute, and chronic) is used when waiting for a confirmed diagnosis.

What is the best ICD-10 code?

When selecting the appropriate ICD-10, you should choose the code that accurately reflects the initial confirmed diagnosis. The best code is the actual disease. Without a confirmed diagnosis, the next best is a sign or symptom. After that, other is the best option. The least appropriate code is unspecified.

Is uveitis anterior or posterior?

Based on the anatomical involvement, uveitis can be classified as anterior, affecting the anterior chamber/iris; intermediate, affecting the vitreous/pars plana; posterior, affecting the retina and choroid; or panuveitis, affecting the anterior chamber, vitreous, and retina/choroid.

Is anterior uveitis clear?

These principles are relevant when coding for uveitis cases. Often, patients present with obvious symptoms and a diagnosis of anterior uveitis is clear. However, determining why the patient has uveitis and uncovering the underlying systemic disease may be possible with additional testing. As the results are reviewed and an etiology becomes apparent, a more definitive uveitis diagnosis and ICD-10 code will be assessed.

When to use unspecified code?

The least appropriate code is unspecified. Only use unspecified when there is not a more definitive code. Code the diagnosis you know. Do not code probable, suspected, or questionable diagnoses, do not you rule out conditions until they are confirmed. These principles are relevant when coding for uveitis cases.

Is anterior uveitis secondary to underlying disease?

When the results are obtained, a more definitive diagnosis may be used. If anterior uveitis is secondary to an underlying disease, the next step is determining if that systemic disease is infectious or noninfectious. The initial ICD-10 codes are replaced with the secondary anterior uveitis code, as appropriate, and the systemic disease is coded as a secondary ICD-10 code. There may be cases where the underlying cause is not identified, and the diagnosis will remain anterior uveitis.

What is UGH syndrome?

Uveitis-Glaucoma-Hyphema (UGH) Syndrome or Ellingson syndrome is a complication of intraocular chafing from intraocular lens (IOL) implants leading to a spectrum of iris transillumination defects and pigmentary dispersion to microhyphemas and hyphemas with elevated intraocular pressure (IOP). It is most commonly caused by chafing from anterior chamber intraocular lenses but can occur from any type of pseudophakic lens. It is characterized by chronic inflammation, cystoid macular edema (CME), secondary iris neovascularization, recurrent hyphemas, and glaucomatous optic neuropathy leading to a loss of vision. Surgical intervention is often required as definitive treatment.

When was UGH syndrome first discovered?

The term UGH Syndrome was first coined by Ellingson in 1978 . He noticed that certain styles of anterior chamber intraocular lenses had warped footplates leading to a rocking motion of the lens and mechanical irritation of adjacent anterior chamber angle structures.

How to prevent UGH syndrome?

During routine cataract surgery, a 1 piece lens and haptics should be placed within the lens capsule. If this is not possible due to intraoperative complications, then there are other lens types and techniques that should be undertaken to prevent uveal disruption from the intraocular lens. A 1 piece lens should not be placed in the sulcus. If there is enough support a 3-piece lens should be placed within the sulcus. Additionally, reverse optic capture of the lens can be attempted by placing the edges under the anterior capsulorhexis. It is important to place the 3 piece lens in the correct orientation within the sulcus as the lens is vaulted. If there is inadequate capsular support then a 3 piece sulcus lens can be fixated via scleral fixation. If an ACIOL is required then the correct size of the lens should be chosen. The general size for ACIOL placement is horizontal corneal white-to-white distance plus 1mm. An incorrectly sized ACIOL can result in UGH syndrome via tilting and haptic chafing on anterior segment structures. The ACIOL is also vaulted and must be placed in the correct orientation. Upside-down lens syndrome is characterized by 'chronic iritis, cystoid macular edema, pupil capture, iris adhesions, and corneal decompensation' due to inverted placement of the Kelman multiflex anterior chamber IOL.

What causes a microhyphema?

The release of red blood cells causes a microhyphema or hyphema. With pigment, red blood cells, and white blood cells in the anterior chamber, the trabecular meshwork can become blocked causing an increase in intraocular pressure.

Can OCT diagnose UGH?

Additionally, optical coherence tomography (OCT) can aid in the guidance of diagnosing CME; however, it is not needed to diagnose UGH syndrome itself.

INITIAL PRESENTATION

Elevated intraocular pressure and "cloudy, hazy" vision of the left eye

CLINICAL COURSE

The patient underwent a pars plana vitrectomy (23 gauge) with removal of the single-piece IOL and placement of a 3-piece sulcus IOL (Acrysof MA60AC, Alcon Laboratories, Ft. Worth, TX). Immediately following the PPV, an Ahmed seton (model FP7, New Word Medical, Rancho Cucamonga, CA) was inserted.

DISCUSSION

Uveitis-glaucoma-hyphema (UGH) syndrome was first described by Ellingson in 1978 and classically included uveitis, glaucoma, and hyphema in the setting of an anterior chamber IOL.

Suggested Citation Format

Cheng L, Fox AR, Kam JP, Alward WLM. Uveitis Glaucoma Hyphema (UGH) Syndrome. EyeRounds.org. posted October 3, 2017; Available from: http://EyeRounds.org/cases/257-UGH-syndrome.htm

What is the medical term for a uveitis-glacoma-hyphaema?

Uveitis-Glaucoma-Hyphaema Syndrome (UGH syndrome, or "Ellingson" Syndrome) is a rare condition caused by the mechanical trauma of an intraocular lens malpositioned over adjacent structures (iris, ciliary body, iridocorneal angle), leading to a spectrum of iris transillumination defects, microhyphaem …

What is UGH syndrome?

Uveitis-Glaucoma-Hyphaema Syndrome (UGH syndrome, or "Ellingson" Syndrome) is a rare condition caused by the mechanical trauma of an intraocular lens malpositioned over adjacent structures (iris, ciliary body, iridocorneal angle), leading to a spectrum of iris transillumination defects, microhyphaemas and pigmentary dispersion, concomitant with elevated intraocular pressure (IOP). UGH Syndrome can also be characterized by chronic inflammation, secondary iris neovascularization, cystoid macular edema (CME). The fundamental step in the pathogenesis of UGH syndrome appears to arise from repetitive mechanical iris trauma by a malpositioned or subluxed IOL. These patients have uncomplicated cataract implants and return for episodes of blurry vision weeks to months after surgery. This may be accompanied by pain, photophobia, erythropsia, anterior uveitis, hyphaema along with raised intraocular pressure. A careful history and examination, as well as appropriate investigations can confirm the diagnostic. Treatment options are IOL Explantation exchange, topical and systemic medication, and cyclophotocoagulation, the placement of a Capsular Tension Ring to redistribute zonular tension and Anti-vascular endothelial growth factor (anti-VEGF) Therapy.