Cataract ICD-10-CM Codes | 2023

What ICD-10 Codes are Used for Cataract?

A cataract is the clouding of the eye's natural lens, resulting in blurred vision and visual impairment. It is one of the most common eye conditions affecting older people. The International Classification of Diseases, 10th Revision (ICD-10) provides a coding system to classify and document various medical conditions, including cataracts. Here are some commonly used ICD-10 codes for cataracts, along with their clinical descriptions:

H25.0 - Age-related nuclear cataract: 

This code describes cataracts that primarily affect the central part of the lens (nucleus) due to aging. It is characterized by gradual vision loss, decreased contrast sensitivity, and increased difficulty with night vision.

H25.1 - Age-related cortical cataract: 

This code is used to indicate cataracts that affect the outer layer (cortex) of the lens. Age-related cortical cataracts typically cause glare, reading difficulty, and vision problems in bright light.

H25.9 - Unspecified age-related cataract: 

This code is used when the specific type of age-related cataract is not mentioned. It covers cases where the documentation does not provide enough information to assign a more specific code.

H26.9 - Unspecified cataract: 

This code is used when the type of cataract is not specified, but it is known that a cataract is present. It may be used when the medical record lacks sufficient information to assign a more specific code.

H26.0 - Infantile and juvenile cataract: 

This code is used to describe cataracts that occur in infants or children. It includes both congenital cataracts (present at birth) and those that develop during childhood. Infantile and juvenile cataracts can cause severe visual impairment if left untreated.

H26.1 - Traumatic cataract: 

This code is used to indicate cataracts that develop as a result of trauma or injury to the eye. Traumatic cataracts can occur immediately after the injury or develop gradually. They require prompt medical attention and may require surgical intervention.

H26.2 - Complicated cataract: 

This code is used to describe cataracts that are associated with other ocular conditions or complications. It includes cataracts occurring in the presence of conditions such as glaucoma, uveitis, or retinal disorders.

H26.3 - Drug-induced cataract:

This code is used when certain medications, such as corticosteroids, or the long-term use of specific drugs cause a cataract. Drug-induced cataracts can develop gradually and may be reversible if the medication is discontinued.

H26.8 - Other specified cataract: 

This code is used for cataracts that do not fall under any specific category mentioned above but have additional specificity documented in the medical record. It covers less common types or presentations of cataracts.

H28.9 - Cataract, unspecified: 

This code is used when the medical record mentions cataracts without providing any further details or specific information regarding the type or cause.

Which Cataract ICD codes are Billable: 

H25.0 - Age-related nuclear cataract: 

Yes, this code is billable. Age-related nuclear cataracts are a specific and well-documented condition, and this code accurately represents the diagnosis for billing purposes.

H25.1 - Age-related cortical cataract: 

Yes, this code is billable. Similar to age-related nuclear cataracts, age-related cortical cataracts are a distinct condition with specific clinical characteristics, making it appropriate for billing purposes.

H25.9 - Unspecified age-related cataract:

Yes, this code is billable. While it represents an unspecified type of age-related cataract, it still indicates the presence of a cataract. It can be used for billing when there is insufficient documentation to assign a more specific code.

H26.9 - Unspecified cataract: 

Yes, this code is billable. When the type of cataract is not specified, but it is known that it is present, this code can be used for billing. However, efforts should be made to document and code the specific type.

H26.0 - Infantile and juvenile cataract: 

Yes, this code is billable. Infantile and juvenile cataracts are distinct conditions that affect a specific age group, making them appropriate for billing purposes.

H26.1 - Traumatic cataract: 

Yes, this code is billable. Traumatic cataracts occur due to a documented injury or trauma to the eye, and this code accurately represents the condition for billing purposes.

H26.2 - Complicated cataract: 

Yes, this code is billable. Complicated cataracts occur in association with other ocular conditions or complications, and this code appropriately captures the complexity of the condition for billing purposes.

H26.3 - Drug-induced cataract: 

Yes, this code is billable. Drug-induced cataracts are a specific type of cataract caused by medication use, and this code accurately represents the condition for billing purposes.

H26.8 - Other specified cataract: 

Yes, this code is billable. Although it covers less common types or presentations of cataracts, it allows for additional specificity in the documentation, making it appropriate for billing purposes.

H28.9 - Cataract, unspecified: 

Yes, this code is billable. While it represents an unspecified cataract without further details, it still indicates the presence of a cataract. It can be used for billing when there is insufficient documentation to assign a more specific code.

Clinical Information

Cataracts are a common eye condition characterized by clouding the eye's natural lens, leading to vision impairment. Here is some clinical information about cataracts presented in bullet points:

• Cataracts occur when the usually clear eye lens becomes cloudy, resulting in blurred or hazy vision.
• The most common cause of cataracts is aging, but they can also develop due to genetics, trauma, certain medications, and systemic diseases like diabetes.
• Symptoms of cataracts include blurry vision, difficulty seeing in low light, increased sensitivity to glare, and reduced color perception.
• Cataracts can affect one or both eyes and progress at different rates, leading to varying levels of visual impairment.
• The diagnosis of cataracts is typically made through a comprehensive eye examination, which may include visual acuity testing, dilated eye evaluation, and assessment of the lens's clarity.
• Cataract surgery is the most effective treatment for cataracts. The cloudy lens is surgically removed during the procedure and replaced with an artificial intraocular lens (IOL). Cataract surgery is generally safe and has a high success rate, resulting in improved vision and quality of life for most patients.
• Following cataract surgery, individuals may experience improved visual acuity, reduced dependence on glasses or contact lenses, and enhanced color perception.
• Regular eye examinations are essential to monitor the progression of cataracts and determine the appropriate time for surgery.

Synonyms Include:

• Opacity of the lens
• Lens clouding
• Ocular opacification
• Lens degeneration
• Lens discoloration
• Lens haziness
• Lens opacity syndrome
• Lens turbidity
• Lens blurring
•  Lens obstruction