ICD-10-CM Billable Code

H26.011

Infantile and juvenile cortical, lamellar, or zonular cataract, right eye

Clinical Classification Guidelines

Medical Intelligence & Overview

ICD-10 code H26.011 refers to a specific type of cataract affecting the right eye in infants and young children. Cataracts are cloudings that develop in the natural lens of the eye, potentially impairing vision. This particular classification indicates the affected eye and details about the cataract's location and nature, which can influence treatment options and prognosis.

Causes & Symptoms

Clinical Causes: Genetic factors or inherited conditions Congenital infections during pregnancy Preterm birth or low birth weight Trauma or injury to the eye during infancy or childhood Metabolic or systemic conditions such as diabetes Presence of other ocular anomalies or syndromes Unknown causes in some cases

Key Symptoms: Noticeable cloudiness or opacity in the eye's lens Reduced visual acuity or blurred vision Nystagmus (involuntary eye movements), especially in infants Sensitivity to bright light or glare Color perception changes or difficulty distinguishing colors In some cases, no symptoms may be apparent early on Strabismus (crossed eyes) if the cataract significantly affects vision development

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a comprehensive eye examination performed by a pediatric ophthalmologist, including:

Treatment Protocols: Management of infantile and juvenile cortical, lamellar, or zonular cataracts depends on severity and impact on vision. 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 H26.011 a billable ICD-10 code?
Yes, H26.011 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H26.011?
Clinical documentation must specify the nature of Infantile and juvenile cortical, lamellar, or zonular cataract, right eye and any associated comorbidities for accurate reporting.

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