ICD-10-CM Billable Code

H16.249

Ophthalmia nodosa, unspecified eye

Clinical Classification Guidelines

Medical Intelligence & Overview

Ophthalmia nodosa is a type of eye inflammation caused by tiny foreign bodies, such as caterpillar hairs or other plant material, becoming embedded in the eye. When the specific source or cause isn’t identified, it is classified under the ICD-10 code H16.249. This condition primarily affects the eyelids, conjunctiva, and cornea, leading to discomfort and potential vision problems if not properly managed. The term 'unspecified eye' indicates that the diagnosis does not specify whether it involves the left or right eye.

Causes & Symptoms

Clinical Causes: Contact with caterpillar or insect hairs or spines Exposure to plant materials, such as thorns or burrs Injury from fine foreign particles entering the eye Handling or working with plants that have embedded hairs or spines Environmental exposure in outdoor settings

Key Symptoms: Redness in the affected eye Itching and irritation Tearing or increased tear production Sensation of foreign body or grittiness Swelling of the eyelids Discomfort or pain, especially when moving the eye Blurred vision in some cases Light sensitivity (photophobia)

Diagnostic & Treatment

Diagnosis Path: Diagnosis of ophthalmia nodosa involves a comprehensive eye examination by an eye care professional. The doctor will look for characteristic signs such as foreign bodies embedded in the conjunctiva or cornea using magnification tools. Additional testing may include staining of the eye tissues to assess damage, as well as slit-lamp examinations to identify microscopic hairs or spines. History of recent outdoor activities or contact with plants can help confirm exposure to potential causative agents.

Treatment Protocols: Treatment strategies focus on removing embedded foreign bodies and reducing inflammation. Methods 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 H16.249 a billable ICD-10 code?
Yes, H16.249 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H16.249?
Clinical documentation must specify the nature of Ophthalmia nodosa, unspecified eye and any associated comorbidities for accurate reporting.

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