2025 ICD-10-CM code H46
Inflammation of the optic nerve. May present with acute vision loss and pain. Often associated with autoimmune disorders, infections, and granulomatous diseases.
Medical necessity for the evaluation and treatment of optic neuritis is established by the presence of signs and symptoms consistent with the condition, such as vision loss, eye pain, and abnormal pupillary reflexes. The medical necessity of specific diagnostic tests, such as MRI, depends on the clinical suspicion for underlying conditions like multiple sclerosis.Treatment is medically necessary to prevent permanent vision loss and manage associated symptoms.
Diagnosis and management of optic neuritis, including a thorough assessment of the patient's medical history, a comprehensive eye examination, and ordering appropriate diagnostic tests (such as visual field testing, optical coherence tomography, and MRI). The clinician should also determine the underlying cause of optic neuritis and initiate appropriate treatment based on the etiology. Treatment may involve corticosteroids, immunomodulatory therapies, or treatment of the underlying infection.
In simple words: Optic neuritis is when your optic nerve, which connects your eye to your brain, gets inflamed. This can cause your vision to worsen quickly, eye soreness, especially when you move your eyes, and changes in how you see colors.
Optic neuritis is a disorder characterized by inflammation of the optic nerve. Causes include autoimmune disorders (such as multiple sclerosis), infections, toxins, drugs, and granulomatous diseases. Symptoms may include acute loss of vision, pain (especially retro-orbital pain aggravated by eye movement), loss of color vision, and reduced contrast sensitivity. In severe cases, it can progress to significant visual loss and an afferent pupillary defect (Marcus-Gunn pupil). Sometimes, optic disc hyperemia and swelling may be observed. The inflammation can affect the portion of the nerve within the globe (neuropapillitis or anterior optic neuritis) or the portion behind the globe (retrobulbar neuritis or posterior optic neuritis).
Example 1: A 30-year-old female presents with sudden onset of blurred vision in her right eye, along with pain on eye movement. An MRI reveals demyelinating lesions consistent with multiple sclerosis, and she is diagnosed with optic neuritis secondary to MS., A 60-year-old male with a history of sarcoidosis experiences gradual vision loss in his left eye. Examination reveals optic disc swelling, and he is diagnosed with optic neuritis related to sarcoidosis., A 10-year-old child develops eye pain and vision changes following a viral infection. After a complete ophthalmologic exam, the child is diagnosed with post-infectious optic neuritis.
The documentation should include a detailed description of the patient’s symptoms (including onset, duration, and character of vision changes, eye pain, and associated symptoms), relevant medical history (including any autoimmune conditions, infections, or toxic exposures), findings from a comprehensive eye examination (including visual acuity, color vision, pupillary reflexes, and optic disc appearance), and results of any diagnostic testing (such as MRI or visual field testing). The documentation should also support the medical necessity of any treatment or interventions.
- Payment Status: Billable
- Specialties:Ophthalmology, Neurology, Optometry
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital