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2025 ICD-10-CM code Q12.0

Congenital cataract.

Coding guidelines for congenital cataracts specify using Q12.0 for any opacity of the lens present at birth, regardless of size or laterality. If the cataract is associated with other conditions, additional codes should be used to reflect those conditions.

Medical necessity for the treatment of congenital cataracts is based on the potential for vision impairment and its impact on the child's development. Early intervention, including surgery and vision rehabilitation, is often necessary to prevent long-term complications.

Diagnosis and treatment of congenital cataracts typically involves ophthalmologists and pediatricians. Ophthalmologists specialize in eye health and perform examinations and surgical procedures if needed. Pediatricians oversee the child's overall well-being and coordinate care with the ophthalmologist.

In simple words: A congenital cataract is when a baby is born with a cloudy lens in their eye, which makes it hard for them to see clearly. It's like having a foggy window in front of their eye. This can happen in one or both eyes.

A congenital cataract is a clouding of the lens of the eye that is present at birth. The lens is normally clear and focuses light onto the retina. This condition can affect one or both eyes.

Example 1: A newborn is diagnosed with a congenital cataract during their initial newborn screening. The cataract is small and doesn't significantly affect vision. Monitoring is recommended., An infant is found to have a large, dense cataract in one eye causing vision impairment. The ophthalmologist recommends cataract surgery and follow-up care to prevent amblyopia (lazy eye)., A child is diagnosed with bilateral congenital cataracts associated with a genetic syndrome. The child undergoes cataract surgery followed by vision rehabilitation and treatment for the underlying syndrome.

Documentation for congenital cataracts should include: details of the eye exam, including the size, location, and density of the cataract; any associated eye abnormalities or systemic conditions; details of the treatment plan, including surgery and follow-up care; results of any additional tests such as genetic testing or imaging studies.

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