2025 ICD-10-CM code H28
(Active) Effective Date: N/A Diseases of the eye and adnexa - Disorders of lens (H25-H28) VII Diseases of the eye and adnexa (H00-H59) Feed
Cataract in diseases classified elsewhere. Code first the underlying disease.
Medical necessity for services related to the cataract must be supported by documentation linking it to the underlying condition.The documentation should demonstrate how the cataract impacts the patient's vision and overall health status.
It is the clinician's responsibility to identify and document both the cataract and the underlying medical condition causing it.Accurate coding requires sequencing the codes correctly, with the underlying disease listed first, followed by the H28 code.
In simple words: This code signifies the presence of a cataract, a clouding of the eye's lens, occurring as a result of another medical condition. It's essential to identify and code the underlying condition first.
Cataract in diseases classified elsewhere. Code first underlying disease, such as: hypoparathyroidism (E20.-), myotonia (G71.1-), myxedema (E03.-), protein-calorie malnutrition (E40-E46). Excludes1: cataract in diabetes mellitus (E08.36, E09.36, E10.36, E11.36, E13.36)
Example 1: A patient with documented hypoparathyroidism (E20.-) also presents with cataracts. In this case, E20.- would be coded first, followed by H28., A patient with myotonic dystrophy (G71.1-) develops a cataract. G71.1- is coded first, followed by H28 to indicate the cataract associated with the dystrophy., A patient diagnosed with myxedema (E03.-) has a cataract. The E03.- code for myxedema is reported first, and then H28 is added to represent the related cataract.
Documentation should clearly specify the type of cataract and the underlying condition.Medical records must explicitly link the cataract to the underlying disease. Any relevant diagnostic tests, including eye examinations and medical evaluations related to the primary condition, should be included.
** For accurate coding and billing, it is crucial to distinguish cataracts caused by other conditions (H28) from other types, like age-related cataracts. Consulting specialized coding resources can offer further guidance.
- Specialties:Ophthalmology, Endocrinology, Internal Medicine, and potentially others depending on the specific underlying condition.
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, and other places depending on the severity of the cataract and underlying condition.