ICD-10-CM Billable Code

H11.43

Conjunctival hyperemia

Clinical Classification Guidelines

Medical Intelligence & Overview

Conjunctival hyperemia, commonly known as red eye, is a condition characterized by redness and increased blood flow in the conjunctiva, the thin clear tissue covering the white part of the eye. This condition can be caused by a variety of factors and often indicates underlying irritation or inflammation. Recognizing the symptoms and understanding possible causes can help in seeking appropriate care and managing the condition effectively.

Causes & Symptoms

Clinical Causes: Infections such as bacterial, viral, or allergic conjunctivitis Allergic reactions to pollen, dust, pet dander, or other allergens Environmental irritants like smoke, pollution, or chemical fumes Eye strain from prolonged screen use or inadequate lighting Dry eyes resulting from insufficient tear production Contact lens wear leading to irritation or infection Injury or trauma to the eye Underlying systemic conditions like autoimmune diseases

Key Symptoms: Redness in one or both eyes, often involving the conjunctiva A gritty or burning sensation in the affected eye Itching or watering of the eyes Sensitivity to light (photophobia) Discharge from the eye that may be watery, mucous, or pus-like Swelling of the eyelids or conjunctiva Blurred vision in some cases Feeling of a foreign body in the eye

Diagnostic & Treatment

Diagnosis Path: Diagnosis of conjunctival hyperemia involves a comprehensive eye examination by a healthcare professional. The eye specialist will assess the redness, check for signs of infection or injury, and may perform additional tests such as slit-lamp examination. The healthcare provider might inquire about associated symptoms, recent exposures, or underlying health conditions to determine the cause. Sometimes, laboratory tests or cultures are performed if an infection is suspected.

Treatment Protocols: Treatment strategies depend on the underlying cause of conjunctival hyperemia. Common 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 H11.43 a billable ICD-10 code?
Yes, H11.43 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H11.43?
Clinical documentation must specify the nature of Conjunctival hyperemia and any associated comorbidities for accurate reporting.

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