ICD-10-CM Billable Code

H16.011

Central corneal ulcer, right eye

Clinical Classification Guidelines

Medical Intelligence & Overview

A central corneal ulcer in the right eye is a serious eye condition characterized by an open sore on the cornea — the transparent front part of the eye. When this ulcer develops centrally, it affects the middle portion of the cornea directly in front of the pupil, which can interfere with vision and lead to more severe complications if left untreated. Recognizing the signs and understanding the underlying causes are essential steps toward managing this condition effectively.

Causes & Symptoms

Clinical Causes: Eye infections caused by bacteria, fungi, viruses, or parasites. Corneal trauma, such as scratches, abrasions, or foreign objects entering the eye. Pre-existing eye diseases, like dry eye syndrome or blepharitis. Improper contact lens use or hygiene, increasing risk of infections. Compromised immune system conditions that impair the eye's ability to heal. Prolonged use of topical eye medications that may irritate the cornea.

Key Symptoms: Severe eye pain or discomfort Redness and swelling of the affected eye Eye tearing or discharge Sensitivity to light (photophobia) Blurred or decreased vision in the affected eye Feeling of a foreign body in the eye Visible ulcer or sore on the cornea under slit-lamp examination

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a comprehensive eye examination performed by an eye care professional. The process includes:

Treatment Protocols: Management of a central corneal ulcer requires prompt and appropriate treatment to prevent complications like scarring or vision loss. Typical approaches include:

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 H16.011 a billable ICD-10 code?
Yes, H16.011 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H16.011?
Clinical documentation must specify the nature of Central corneal ulcer, right eye and any associated comorbidities for accurate reporting.

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