Outpatient Facility Coding Alert

Question: We have a patient diagnosed with colobama, but I'm not sure which ICD-10 code to report. Can you help me?

Codify Subscriber

Answer: When patients have colobomas, they were born without certain tissues that form their eyes. These colobomas are frequently seen in the iris because they are more obvious there since it's noticeable when part of the iris is missing. However, colobomas can also affect the other areas that aren't as easy to see on visual examination of the patient and can be slower to diagnose. When patients present with this condition, they could complain of the following symptoms, among others, which you should report in the absence of a confirmed diagnosis:

• H53.8 -  Other visual disturbances
• H54.5x - Low vision, one eye
• H53.45x - Other localized visual field defect.

If the ophthalmologist definitively diagnoses the patient with a coloboma, you'll bill the claim using the more specific code, depending on the location. Several options are listed below:

• Q12.2 - Coloboma of lens
• Q13.0 - Coloboma of iris
• Q14.2 - Congenital malformation of optic disc
• Q14.8 - Other congenital malformations of posterior segment of eye(for coloboma of the fundus).

If other conditions are associated with the coloboma, you can report them as well (such as glaucoma or strabismus), but do not report the signs and symptoms if the physician has definitively diagnosed the patient with coloboma.

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