ICD-10-CM Billable Code

H31.013

Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral

Clinical Classification Guidelines

Medical Intelligence & Overview

Macula scars of the posterior pole are areas of scarring located in the central part of the retina responsible for sharp, detailed vision. When these scars are bilateral, they affect both eyes, potentially impacting vision significantly. These scars often result from previous inflammation (postinflammatory) or trauma (post-traumatic), leading to permanent changes in the retina. Recognizing the condition's causes, symptoms, and available management options can help patients understand their diagnosis better.

Causes & Symptoms

Clinical Causes: Previous inflammatory eye conditions, such as choroiditis or uveitis, leading to retinal scarring Traumatic injuries to the eye causing damage to the macula region Age-related macular degeneration or other degenerative processes leading to scarring Post-surgical complications or retinal tears that heal with scarring Infections that affect the retina, such as toxoplasmosis or cytomegalovirus retinitis

Key Symptoms: Gradual loss of central vision, making activities like reading or recognizing faces difficult Blurring or distortion of fine visual detail Presence of dark spots or scotomas in the central visual field Color perception changes in the affected areas Difficulty in adapting to low light conditions or glare

Diagnostic & Treatment

Diagnosis Path: Diagnosis of bilateral macula scars of the posterior pole primarily involves a thorough eye examination by an eye specialist. Diagnostic procedures include:

Treatment Protocols: While scarring in the macula is typically permanent, treatment focuses on managing symptoms and preventing further damage. Available 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 H31.013 a billable ICD-10 code?
Yes, H31.013 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H31.013?
Clinical documentation must specify the nature of Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral and any associated comorbidities for accurate reporting.

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