ICD-10-CM Billable Code

H04.13

Lacrimal cyst

Clinical Classification Guidelines

Inclusion Terms

  • Lacrimal cystic degeneration

Medical Intelligence & Overview

A lacrimal cyst is a benign fluid-filled sac that can develop near the tear-producing structures in the eye. Often associated with lacrimal cystic degeneration, this condition involves the formation of a cyst in the lacrimal sac or sac area, which can cause discomfort or visible swelling. Although generally not serious, understanding its features can help in seeking appropriate eye care and management.

Causes & Symptoms

Clinical Causes: Congenital abnormalities present from birth Blockage in the tear drainage system Infection or inflammation affecting the lacrimal sac Trauma leading to disruption in tear drainage pathways Degenerative changes in lacrimal tissues

Key Symptoms: Swelling or a noticeable lump on the eyelid near the inner corner Discomfort or a feeling of fullness in the affected area Tearing or excessive watery eyes Redness or mild inflammation around the swelling Rarely, recurrent infections causing pain or pus discharge

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a thorough eye examination, including inspection of the swelling and assessment of tear drainage. In some cases, imaging studies such as ultrasound or MRI may be performed to evaluate the cyst's size and location. A healthcare provider may also perform a dye test or irrigation to determine if the tear drainage pathway is blocked.

Treatment Protocols: Management options vary based on the cyst's size and symptoms. 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 H04.13 a billable ICD-10 code?
Yes, H04.13 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H04.13?
Clinical documentation must specify the nature of Lacrimal cyst and any associated comorbidities for accurate reporting.

Cite this Clinical Reference