2024 ICD-10-CM Diagnosis Code H57.9

Approximate Synonyms

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

• Acute disease of eye
• Anomaly of eye
• Cataract due to inflammatory disorder
• Cataract due to inflammatory disorder
• Cataract due to inflammatory disorder
• Cataract of bilateral eyes due to inflammatory disorder
• Cataract of left eye due to inflammatory disorder
• Cataract of left eye due to inflammatory disorder
• Cataract of left eye due to ocular disease
• Cataract of right eye due to inflammatory disorder
• Cataract of right eye due to inflammatory disorder
• Cataract of right eye due to ocular disease
• Chronic disease of ocular adnexa
• Diffuse mesangial sclerosis
• Diffuse mesangial sclerosis with ocular abnormalities
• Disorder of anterior segment of eye
• Disorder of bilateral eyes
• Disorder of eye proper co-occurrent with human immunodeficiency virus infection
• Disorder of eye region
• Disorder of left eye
• Disorder of ocular adnexa
• Disorder of posterior segment of eye
• Disorder of right eye
• Eye not working properly
• Eye symptom
• Glaucoma due to ocular vascular disorder
• Glaucoma of bilateral eyes due to ocular vascular disorder
• Glaucoma of left eye due to ocular vascular disorder
• Glaucoma of right eye due to ocular vascular disorder
• Hereditary disorder of the visual system
• Immunoglobulin G4 related disease
• Immunoglobulin G4 related ophthalmic disease
• Lesion of eye
• Limited duction associated with other condition of eye
• Neonatal ophthalmologic disorder
• Ophthalmological treatment changed
• Ophthalmological treatment started
• Restrictive ophthalmopathy
• Thyroid eye disease
• Visual system complication of procedure
• Visual system disorder

Code Edits

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

• Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

H57.9 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.

Convert H57.9 to ICD-9-CM

• ICD-9-CM Code: 379.40 - Abn pupil function NOS
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
• ICD-9-CM Code: 379.90 - Eye disorder NOS
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
• ICD-9-CM Code: V41.1 - Eye problems NEC
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

Eye Diseases

Some eye problems are minor and don't last long. But some can lead to a permanent loss of vision.

Common eye problems include:

• Refractive errors
• Cataracts - clouded lenses
• Optic nerve disorders, including glaucoma
• Retinal disorders - problems with the nerve layer at the back of the eye
• Macular degeneration - a disease that destroys sharp, central vision
• Diabetic eye problems
• Conjunctivitis - an infection also known as pink eye

Your best defense is to have regular checkups, because eye diseases do not always have symptoms. Early detection and treatment could prevent vision loss. See an eye care professional right away if you have a sudden change in vision, if everything looks dim, or if you see flashes of light. Other symptoms that need quick attention are pain, double vision, fluid coming from the eye, and inflammation.

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 - 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. This was the first year ICD-10-CM was implemented into the HIPAA code set.