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2025 ICD-10-CM code H55.04

Dissociated nystagmus.It is an involuntary, rhythmic oscillation of the eyes, where the movements of the two eyes are not conjugate (i.e. not in the same direction).

The ICD-10-CM code H55.04 should be used to report dissociated nystagmus. If a causal relationship between the nystagmus and another condition is established, an additional code should be used to report the underlying etiology.

Medical necessity for services related to dissociated nystagmus is established by the presence of signs, symptoms, and functional impairments related to the condition. This may include decreased visual acuity, difficulty with eye tracking, double vision, and other visual disturbances. The medical record should clearly document the impact of the nystagmus on the patient's daily activities and quality of life.

Diagnosis and management of dissociated nystagmus typically falls under the purview of ophthalmologists and neuro-ophthalmologists. They are responsible for assessing the underlying cause, determining the appropriate treatment strategy, and monitoring the patient's progress.

In simple words: Dissociated nystagmus is a condition where your eyes make involuntary, jerky movements, and each eye moves differently from the other. Instead of moving together smoothly, they might move in different directions or at different speeds.

Dissociated nystagmus is a condition characterized by uncoordinated eye movements, where the eyes move independently of each other, rather than together. This can manifest as different directions, amplitudes, or frequencies of movement in each eye.

Example 1: A patient presents with complaints of blurry vision and difficulty focusing. Upon examination, the ophthalmologist observes dissociated nystagmus, with the right eye exhibiting horizontal oscillations and the left eye showing minimal movement. Further investigation reveals a history of multiple sclerosis, which is identified as the underlying cause of the nystagmus., An infant is brought to the pediatrician for a routine check-up. During the examination, the pediatrician notices that the infant's eyes are moving independently, with one eye moving more rapidly than the other. This is diagnosed as congenital dissociated nystagmus., Following a head injury, a patient experiences double vision and involuntary eye movements.An ophthalmological examination reveals dissociated nystagmus, likely caused by damage to the neural pathways controlling eye movement.

Documentation should include a detailed description of the nystagmus, including the direction, amplitude, and frequency of eye movements in each eye. Any associated symptoms, such as blurred vision, dizziness, or oscillopsia, should be noted. Diagnostic testing results, such as MRI or CT scans, should be included if performed. The underlying cause of the nystagmus, if known, should also be documented.

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