2025 ICD-10-CM code H26.3
(Active) Effective Date: N/A Diseases of the eye and adnexa - Disorders of lens 7 Feed
Drug-induced cataract. Toxic cataract.
Medical necessity for the treatment of a drug-induced cataract is established when the cataract significantly impairs the patient's vision and interferes with their daily activities. The impairment should be documented and quantified using visual acuity testing and other relevant clinical findings. Treatment, usually in the form of cataract surgery, is deemed medically necessary when it is expected to restore or improve vision and quality of life.
Diagnosis and management of drug-induced cataracts usually falls under the purview of ophthalmologists. They are responsible for confirming the diagnosis through a comprehensive eye exam, assessing the severity of the cataract, discussing treatment options with the patient, and performing any necessary surgical interventions. If the cataract is linked to a specific medication, they may consult with the prescribing physician regarding alternative drug therapies.
In simple words: This code signifies a cataract (clouding of the eye's lens) that has developed due to the use of certain medications.
Drug-induced cataract. Toxic cataract. Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
Example 1: A 65-year-old patient with a history of long-term corticosteroid use for rheumatoid arthritis develops a drug-induced cataract, confirmed by an ophthalmologist during a routine eye exam., A 40-year-old patient on long-term amiodarone therapy for a heart condition presents with vision changes. Upon examination, the ophthalmologist diagnoses a drug-induced cataract., A 25-year-old patient undergoing chemotherapy develops a drug-induced cataract as a side effect of the medication. The ophthalmologist monitors the cataract's progression and recommends appropriate treatment.
Diagnosis of drug-induced cataract requires detailed documentation of the patient's medication history, including the specific drugs used and the duration of use. Comprehensive eye examination findings should also be recorded, including visual acuity measurements, slit-lamp examination results, and any other diagnostic tests performed. The connection between the medication and cataract development, along with any discussions of treatment options, should be clearly documented.
** Excludes1: congenital cataract (Q12.0). Excludes2: certain conditions originating in the perinatal period (P04-P96), certain infectious and parasitic diseases (A00-B99), complications of pregnancy, childbirth and the puerperium (O00-O9A), congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99), diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-), endocrine, nutritional and metabolic diseases (E00-E88), injury (trauma) of eye and orbit (S05.-), injury, poisoning and certain other consequences of external causes (S00-T88), neoplasms (C00-D49), symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94), syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71).
- Specialties:Ophthalmology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center