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2025 ICD-10-CM code H26.0

This code refers to a cataract present from infancy or during childhood.

Excludes1: congenital cataract (Q12.0). Ensure the documentation clearly specifies infantile/juvenile rather than congenital onset to justify using H26.0 instead of Q12.0.

Medical necessity for services related to H26.0 hinges on the impact of the cataract on the child's visual development. Intervention is often deemed necessary if the cataract obstructs vision enough to hinder normal development, learning, and overall quality of life.Early intervention is often crucial in preventing long-term visual impairment.

Diagnosis and management of infantile and juvenile cataracts fall under the purview of ophthalmologists.They assess the severity of the cataract, monitor its progression, and determine the appropriate course of action, which may include surgical intervention or other treatments.

In simple words: This code indicates the presence of a cataract in infants or children, making it difficult for them to see clearly.

Infantile and juvenile cataract is a clouding of the lens of the eye that is present from infancy (congenital) or develops during childhood.The lens, situated behind the pupil, plays a crucial role in focusing light onto the retina for clear vision. A cataract interferes with this process, causing blurry vision, sensitivity to light and potentially other vision problems.

Example 1: A 6-month-old infant is brought to the ophthalmologist because the parents noticed a whitish appearance in the pupil. Upon examination, a congenital cataract is diagnosed, and H26.0 is used., An 8-year-old child experiences increasingly blurry vision.An ophthalmological evaluation reveals a juvenile cataract, necessitating the use of code H26.0., A newborn screening detects a cataract in one eye.The code H26.0 is assigned, even if the cataract does not significantly impair vision initially, as follow-up and monitoring are essential.

Documentation for H26.0 should include the type of cataract, laterality (which eye is affected), visual acuity measurements, and any associated conditions. Details about the age of onset are crucial to differentiate between infantile and juvenile forms.

** It is important to distinguish H26.0 from other types of cataracts, such as those caused by trauma or underlying medical conditions, which have different codes.If applicable, external cause codes (e.g., injury codes) should be used in conjunction with H26.0 to provide a comprehensive picture of the condition.

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