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Home/Diagnosis/ICD-10 Coding for Proptosis

ICD-10 Coding for Proptosis

H05.241
H05.243

Complete ICD-10-CM coding and documentation guide for icd-10 coding for proptosis includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Exophthalmos
Eye Bulging
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Key Information: ICD-10 Coding for Proptosis

Essential facts and insights about ICD-10 Coding for Proptosis

Use ICD-10 code H05.241 for constant exophthalmos, right eye, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Constant exophthalmos, right eye

Billable Code
H05.241
Billable

Diagnostic Criteria

clinical:
  • • Hertel measurement ≥22mm OD
documentation:
  • • Documented laterality

Applicable To

  • • Proptosis of the right eye

Important Notes

  • • Ensure laterality is documented to avoid unspecified codes.

Constant exophthalmos, bilateral

Billable Code
H05.243
Billable

Diagnostic Criteria

clinical:
  • • Hertel measurement showing ≥2mm asymmetry from baseline or >21mm in both eyes

Applicable To

  • • Proptosis of both eyes

Important Notes

  • • Ensure bilateral involvement is documented to avoid unspecified codes.
Ancillary Codes

Additional codes that may be used with this diagnosis

E05.00

Thyrotoxicosis with diffuse goiter without thyrotoxic crisis

Use as primary when proptosis is due to thyroid eye disease.

Frequently Asked Questions

What is the ICD-10 code for proptosis?

The ICD-10 code for proptosis depends on laterality: H05.241 for right eye, H05.242 for left eye, and H05.243 for bilateral.

How is proptosis documented for ICD-10 coding?

Proptosis documentation should include laterality, Hertel measurements, and any underlying conditions like thyroid eye disease.

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