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2025 ICD-10-CM code H04.22

Epiphora due to insufficient drainage.

Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition.

Medical necessity for treatment is established by documenting the symptoms, diagnostic findings confirming insufficient drainage, and impact on the patient's quality of life.

Clinicians diagnose epiphora based on medical history, symptoms, and an eye exam. Tests may include tear analysis. Treatment depends on the cause and may involve flushing the eye, antibiotics, antiallergens, or surgery.

In simple words: Watery eyes caused by tear ducts not draining properly.

Epiphora due to insufficient drainage refers to excessive tearing due to a blockage or malfunction of the tear ducts.

Example 1: A patient presents with constant watery eyes and a gritty feeling. Upon examination, the tear ducts are found to be partially blocked, causing insufficient drainage and resulting in epiphora., A patient experiences excessive tearing and redness in one eye following a cold. The diagnosis is epiphora due to insufficient drainage caused by inflammation of the lacrimal ducts., An elderly patient reports chronic watery eyes. The ophthalmologist identifies age-related narrowing of the tear ducts as the cause of the insufficient drainage and subsequent epiphora.

Documentation should specify the type of epiphora, affected eye (right, left, bilateral), and underlying cause.

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