ICD-10-CM Billable Code

H26.211

Cataract with neovascularization, right eye

Clinical Classification Guidelines

Medical Intelligence & Overview

Cataracts are a common eye condition characterized by clouding of the natural lens, leading to blurry vision and, if untreated, potential vision loss. When combined with neovascularization—a condition where abnormal new blood vessels grow within the eye—this complication can worsen the severity of eye damage. Specifically, the ICD-10 code H26.211 refers to a cataract with neovascularization affecting the right eye. This condition requires careful monitoring and management to preserve vision and prevent further ocular complications.

Causes & Symptoms

Clinical Causes: Age-related changes: The most common cause, especially in older adults. Diabetes mellitus: Elevated blood sugar levels can promote abnormal blood vessel growth in the eye. Retinal vein occlusion: Blockage of retinal veins can lead to neovascularization. Chronic inflammation or uveitis: Persistent eye inflammation may contribute to abnormal vessel growth. Ocular ischemia: Reduced blood flow to the eye can stimulate new vessel formation. Previous eye surgeries or trauma: Past injuries or procedures can predispose to neovascular changes.

Key Symptoms: Gradual decline in vision clarity Difficulty seeing in low-light conditions Sudden vision changes or floaters Possible signs of increased intraocular pressure Visual distortion or overlapping images In some cases, pain or discomfort if complications such as glaucoma develop

Diagnostic & Treatment

Diagnosis Path: Visual acuity tests to evaluate the sharpness of vision Slit-lamp examination to observe the lens and anterior segment of the eye Fundus examination to assess the retina and detect neovascularization Imaging techniques such as fluorescein angiography to visualize abnormal blood vessels Intraocular pressure measurement to check for glaucoma or other issues

Treatment Protocols: Surgical removal of the clouded lens via cataract extraction, often replaced with an intraocular lens implant Laser therapy, such as panretinal photocoagulation, to control abnormal blood vessel growth Medications, including anti-vascular endothelial growth factor (anti-VEGF) injections, to inhibit neovascularization Management of underlying conditions like diabetes to reduce risks Monitoring intraocular pressure and treatment of associated glaucoma if present Regular follow-up appointments to track eye health and adjust treatment plans

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is H26.211 a billable ICD-10 code?
Yes, H26.211 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H26.211?
Clinical documentation must specify the nature of Cataract with neovascularization, right eye and any associated comorbidities for accurate reporting.

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