Complete ICD-10-CM coding and documentation guide for icd-10 coding for bilateral dry eye syndrome includes clinical validation requirements, medical necessity guidelines, and coding policies.
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Essential facts and insights about ICD-10 Coding for Bilateral Dry Eye Syndrome
Use ICD-10 code H04.123 for dry eye syndrome of bilateral lacrimal glands, ensuring proper documentation in clinical notes.
Additional codes that may be used with this diagnosis
Punctate keratitis
Use if punctate keratitis is present alongside dry eye.
Epiphora complicating dry eye
Use if epiphora is present as a complication.
The ICD-10 code for bilateral dry eye syndrome with lacrimal gland involvement is H04.123. For general bilateral dry eye not specified as Sjögren's, use H04.13.
Document bilateral dry eye syndrome by noting specific test results such as Schirmer’s test and TBUT, and confirm bilateral involvement in the clinical notes.