Version 2024

2024 ICD-10-CM Diagnosis Code H18.513

Endothelial corneal dystrophy, bilateral

ICD-10-CM Code:: H18.513
ICD-10 Code for:: Endothelial corneal dystrophy, bilateral
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
Code Navigator:

Code Information
Approximate Synonyms
Clinical Classification
Clinical Information
Tabular List of Diseases and Injuries
Diagnostic Related Groups Mapping
Replacement Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Diseases of the eye and adnexa
(H00–H59)
- Disorders of sclera, cornea, iris and ciliary body
  (H15-H22)
  - Other disorders of cornea
    (H18)

H18.513 is a billable diagnosis code used to specify a medical diagnosis of endothelial corneal dystrophy, bilateral. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Bilateral dystrophy of posterior surface of cornea of eyes
Bilateral iridocorneal endothelial syndrome of eyes
Chandler syndrome
Iridocorneal endothelial syndrome
Iridocorneal endothelial syndrome of left eye
Iridocorneal endothelial syndrome of right eye

Clinical Classification

Clinical Category is Cornea and external disease
CCSR Category Code: EYE001
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

Iridocorneal Endothelial Syndrome
a grouping of three closely linked conditions: iris nevus (or cogan-reese) syndrome, chandler syndrome, and essential (progressive) iris atrophy. the most common features of this syndrome are the movement of endothelial cells off the cornea onto the iris leading to corneal swelling, distortion of the iris, and variable degrees of distortion of the pupil. the abnormal cell movement plugs fluid outflow channels of the eye causing glaucoma.
Glaucoma
an ocular disease, occurring in many forms, having as its primary characteristics an unstable or a sustained increase in the intraocular pressure which the eye cannot withstand without damage to its structure or impairment of its function. the consequences of the increased pressure may be manifested in a variety of symptoms, depending upon type and severity, such as excavation of the optic disk, hardness of the eyeball, corneal anesthesia, reduced visual acuity, seeing of colored halos around lights, disturbed dark adaptation, visual field defects, and headaches. (dictionary of visual science, 4th ed)
Iridocorneal Endothelial Syndrome
a group of disorders characterized by the presence of an abnormal inner layer of the cornea. this abnormality results in iris distortion, corneal swelling, pupil distortion, and glaucoma. it usually affects only one eye.

H18.513 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
124	OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT	02	1.3219
125	OTHER DISORDERS OF THE EYE WITHOUT MCC	02	0.7975

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Replacement Code

H18513 replaces the following previously assigned ICD-10-CM code(s):

H18.51 - Endothelial corneal dystrophy

Patient Education

Corneal Disorders

Your cornea is the outermost layer of your eye. It is clear and shaped like a dome. The cornea helps to shield the rest of the eye from germs, dust, and other harmful matter. It also helps your eye to focus. If you wear contact lenses, they float on top of your corneas.

Problems with the cornea include:

Refractive errors
Allergies
Infections
Injuries
Dystrophies - conditions in which parts of the cornea lose clarity due to a buildup of cloudy material

Treatments of corneal disorders include medicines, corneal transplantation, and corneal laser surgery.

NIH: National Eye Institute

[Learn More in MedlinePlus]

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - Code Added, effective from 10/1/2020 through 9/30/2021

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.