2025 ICD-10-CM code H26.1
(Active) Effective Date: N/A Diseases of the eye and adnexa - Disorders of lens 7 Feed
Traumatic cataract. This code requires an additional external cause code (Chapter 20) to identify the cause of the injury.
Medical necessity for surgical intervention is determined by the severity of visual impairment and its impact on the patient's daily activities. The presence of a documented traumatic event causing the cataract is essential for establishing medical necessity.
Diagnosis and treatment by ophthalmologist. Evaluation may include visual acuity tests, slit-lamp examination, and imaging studies. Treatment might involve surgical removal of the cataract and implantation of an intraocular lens.
In simple words: This code signifies a cataract that developed due to an eye injury.
Traumatic cataract resulting from injury or trauma to the eye.
Example 1: A 30-year-old male presents with blurred vision in his right eye following a baseball injury two weeks prior. Examination reveals a traumatic cataract., A 55-year-old female presents with decreased vision in her left eye after a car accident one month ago. Diagnostic imaging confirms a traumatic cataract., A construction worker sustains an eye injury from a metal shard. Subsequent examination shows a developing traumatic cataract.
Details of the traumatic event causing the cataract, including date, time, and mechanism of injury. Complete eye exam findings documenting visual acuity, lens opacity, and any other associated ocular damage. Diagnostic imaging reports, if applicable (e.g., ultrasound, CT scan). Medical necessity for any procedures performed (e.g., cataract surgery).
- Payment Status: Active
- Specialties:Ophthalmology
- Place of Service:Office, On Campus-Outpatient Hospital,Ambulatory Surgical Center, Inpatient Hospital