ICD-10-CM Billable Code

S04.011

Injury of optic nerve, right eye

Clinical Classification Guidelines

Medical Intelligence & Overview

An injury to the optic nerve in the right eye, classified under ICD-10 code S04.011, involves damage to the nerve responsible for transmitting visual information from the eye to the brain. This type of injury can significantly impact vision and requires prompt medical evaluation. The optic nerve is a vital component of the visual pathway, and injury to this nerve can result from trauma, such as a blow to the eye, or other types of trauma to the head and face. Recognizing the symptoms and seeking immediate care are crucial steps in managing this condition.

Causes & Symptoms

Clinical Causes: Trauma from blunt or penetrating injuries to the eye or head Car accidents involving impact to the face or head Sports injuries that cause direct trauma to the eye area Falls resulting in facial injury Ballistic injuries or other penetrating trauma Complications from surgical procedures involving the eye or nearby structures

Key Symptoms: Sudden loss or decrease in vision in the right eye Pain or discomfort around the eye or behind it Decreased visual acuity Visual field defects, such as areas of vision loss Swelling or bruising around the eye Dilated pupil in the affected eye In some cases, bleeding or fluid leakage from around the eye

Diagnostic & Treatment

Diagnosis Path: Diagnosis involves a thorough clinical examination by an eye specialist, including visual acuity tests and inspection of the eye. Additional diagnostic procedures may include:

Treatment Protocols: Treatment strategies are aimed at preventing further damage and promoting recovery where possible. 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 S04.011 a billable ICD-10 code?
Yes, S04.011 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report S04.011?
Clinical documentation must specify the nature of Injury of optic nerve, right eye and any associated comorbidities for accurate reporting.

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