2022 ICD-10-CM Code H40.1231

Low-tension glaucoma, bilateral, mild stage

Version 2021

Valid for Submission

ICD-10:H40.1231
Short Description:Low-tension glaucoma, bilateral, mild stage
Long Description:Low-tension glaucoma, bilateral, mild stage

Code Classification

H40.1231 is a billable diagnosis code used to specify a medical diagnosis of low-tension glaucoma, bilateral, mild stage. The code H40.1231 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.

The code H40.1231 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

The code H40.1231 is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Primary Open-angle Glaucoma (poag): Optic Nerve Evaluation , Primary Open-angle Glaucoma (poag): Reduction Of Intraocular Pressure (iop) By 15% Or Documentation Of A Plan Of Care.

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

Convert H40.1231 to ICD-9 Code

Quality Payment Program Measures

When code H40.1231 is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.

Quality Measure Description Quality Domain Measure Type High Priority Submission Methods
Primary Open-Angle Glaucoma (POAG): Optic Nerve EvaluationPercentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months.Effective Clinical CareProcessNOClaims, Electronichealthrecord, Registry
Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of CarePercentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) whose glaucoma treatment has not failed (the most recent IOP was reduced by at least 15% from the pre-intervention level) OR if the most recent IOP was not reduced by at least 15% from the pre-intervention level, a plan of care was documented within the 12 month performance period.Communication and Care CoordinationOutcomeYESClaims, Registry

Information for Patients


Glaucoma

Glaucoma is a group of diseases that can damage the eye's optic nerve. It is a leading cause of blindness in the United States. It usually happens when the fluid pressure inside the eyes slowly rises, damaging the optic nerve. Often there are no symptoms at first. Without treatment, people with glaucoma will slowly lose their peripheral, or side vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains.

A comprehensive eye exam can tell if you have glaucoma. People at risk should get eye exams at least every two years. They include

There is no cure, but glaucoma can usually be controlled. Early treatment can help protect your eyes against vision loss. Treatments usually include prescription eyedrops and/or surgery.

NIH: National Eye Institute


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Code History

  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)