MAR 04, 2016
How to Code for Infant Nasal Lacrimal Duct Obstruction
Question: Depending upon the payer, we receive denials for infants with nasal lacrimal duct obstruction. Is there one ICD-10 code that fits all payers’ requirements?
Answer: . Unfortunately not one diagnosis fits all payers. From the Coding Coach, Complete Ophthalmic Reference, consider any/all of the following.
- H04.011 Acute dacryoadenitis, right lacrimal gland
- H04.012 Acute dacryoadenitis, left lacrimal gland
- H04.013 Acute dacryoadenitis, bilateral lacrimal glands
- H04.021 Chronic dacryoadenitis, right lacrimal gland
- H04.022 Chronic dacryoadenitis, left lacrimal gland
- H04.023 Chronic dacryoadenitis, bilateral lacrimal glands
- H04.121 Dry eye syndrome of right lacrimal gland
- H04.122 Dry eye syndrome of left lacrimal gland
- H04.123 Dry eye syndrome of bilateral lacrimal glands
- H04.211 Epiphora due to excess lacrimation, right lacrimal gland
- H04.212 Epiphora due to excess lacrimation, left lacrimal gland
- H04.213 Epiphora due to excess lacrimation, bilateral lacrimal glands
- H04.221 Epiphora due to insufficient drainage, right lacrimal gland
- H04.222 Epiphora due to insufficient drainage, left lacrimal gland
- H04.223 Epiphora due to insufficient drainage, bilateral lacrimal glands
- H04.311 Phlegmonous dacryocystitis of right lacrimal passage
- H04.312 Phlegmonous dacryocystitis of left lacrimal passage
- H04.313 Phlegmonous dacryocystitis of bilateral lacrimal passages
- H04.321 Acute dacryocystitis of right lacrimal passage (dacryopericystitis)
- H04.322 Acute dacryocystitis of left lacrimal passage (dacryopericystitis)
- H04.323 Acute dacryocystitis of bilateral lacrimal passages (dacryopericystitis)
- H04.331 Acute lacrimal canaliculitis of right lacrimal passage
- H04.332 Acute lacrimal canaliculitis of left lacrimal passage
- H04.333 Acute lacrimal canaliculitis of bilateral lacrimal passages
- H04.411 Chronic dacryocystitis of right lacrimal passage
- H04.412 Chronic dacryocystitis of left lacrimal passage
- H04.413 Chronic dacryocystitis of bilateral lacrimal passages
- H04.431 Chronic lacrimal mucocele of right lacrimal passage
- H04.432 Chronic lacrimal mucocele of left lacrimal passage
- H04.433 Chronic lacrimal mucocele of bilateral lacrimal passages
- H04.511 Dacryolith of right lacrimal passage
- H04.512 Dacryolith of left lacrimal passage
- H04.513 Dacryolith of bilateral lacrimal passages
- H04.531 Neonatal obstruction of right nasolacrimal duct, Excludes1: congenital stenosis and stricture of lacrimal duct (Q10.5)
- H04.532 Neonatal obstruction of left nasolacrimal duct, Excludes1: congenital stenosis and stricture of lacrimal duct (Q10.5)
- H04.533 Neonatal obstruction of bilateral nasolacrimal duct, Excludes1: congenital stenosis and stricture of lacrimal duct (Q10.5)
- H04.541 Stenosis of right lacrimal canaliculi
- H04.542 Stenosis of left lacrimal canaliculi
- H04.543 Stenosis of bilateral lacrimal canaliculi
- H04.551 Acquired stenosis of right nasolacrimal duct
- H04.552 Acquired stenosis of left nasolacrimal duct
- H04.553 Acquired stenosis of bilateral nasolacrimal duct
- H04.561 Stenosis of right lacrimal punctum
- H04.562 Stenosis of left lacrimal punctum
- H04.563 Stenosis of bilateral lacrimal punctum
- H04.571 Stenosis of right lacrimal sac
- H04.572 Stenosis of left lacrimal sac
- H04.573 Stenosis of bilateral lacrimal punctum
- H04.611 Lacrimal fistula right lacrimal passage
- H04.612 Lacrimal fistula left lacrimal passage
- H04.613 Lacrimal fistula bilateral lacrimal passages
- H04.811 Granuloma of right lacrimal passage
- H04.812 Granuloma of left lacrimal passage
- H04.813 Granuloma of bilateral lacrimal passages
- Q10.4 Absence and agenesis of lacrimal apparatus
- Q10.5 Congenital stenosis and stricture of lacrimal duct
- Q10.6 Other congenital malformations of lacrimal apparatus
Remember, if payers covered the diagnosis in ICD-9, they should cover the ICD-10 cross-walk as well.