ICD-10-CM Billable Code

H54.2X12

Low vision right eye category 1, low vision left eye category 2

Clinical Classification Guidelines

Medical Intelligence & Overview

Low vision is a visual impairment that cannot be corrected fully with regular glasses, contact lenses, medication, or surgery. It often significantly impacts daily activities, even with the best possible corrective measures. The ICD-10 code H54.2X12 refers specifically to a person experiencing low vision in the right eye classified as category 1 and in the left eye as category 2, indicating different degrees of visual impairment in each eye. This condition can affect an individual’s independence, mobility, and quality of life, and requires a comprehensive approach to management and support.

Causes & Symptoms

Clinical Causes: Age-related macular degeneration Diabetic retinopathy Glaucoma Retinal detachment Optic nerve damage Corneal scars or opacities Congenital eye disorders Trauma or injury to the eye Infections leading to scarring or damage Neurological conditions affecting vision

Key Symptoms: Reduced clarity of vision despite correction Difficulty recognizing faces or reading small print Need for brighter lights to see clearly Difficulty seeing in low light conditions Visual distortions or blurriness Increased glare sensitivity Loss of peripheral vision Trouble adapting to changes in lighting Difficulty performing detailed tasks

Diagnostic & Treatment

Diagnosis Path: Diagnosis of low vision involves a comprehensive eye examination performed by an eye care professional. The process typically includes assessing visual acuity using standardized eye charts, examining the health of the retina, optic nerve, and other eye structures, and ruling out reversible causes of vision impairment. The classification into categories (such as category 1 for the right eye and category 2 for the left eye) is based on the degree of visual impairment determined during testing. Additional tests like visual field assessments may be employed to evaluate peripheral vision loss.

Treatment Protocols: While low vision cannot always be fully corrected, various strategies and aids can help individuals maximize their remaining vision. Treatments may 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 H54.2X12 a billable ICD-10 code?
Yes, H54.2X12 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H54.2X12?
Clinical documentation must specify the nature of Low vision right eye category 1, low vision left eye category 2 and any associated comorbidities for accurate reporting.

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