Pediatric Coding Alert

You must document the site if you want to collect under ICD-10.

A stye is an infection of the glands on the eyelid, and is often noticed by concerned parents who see a bump on their child’s eyelid. Some can cause pain in the patient, while others may be painless. A stye can often resolve on its own or by using home remedies, and in some cases, you may prescribe medication. But how to code this condition may throw you for a loop when ICD-10 goes into effect this fall, and your practice should take note of this somewhat dramatic change.

ICD-9 Coding Rules

In most cases under ICD-9, you report 373.11 (Hordeolum externum) when the practitioner diagnoses a patient with a stye.

ICD-10 Changes

After Oct. 1, 2013, your coding options will depend upon not only which eye (right or left) the pediatrician treated, but also which eyelid (upper or lower), expanding the stye section of ICD-10 out to the following seven codes:

• H00.011 (Hordeolum externum right upper eyelid)
• H00.012 (Hordeolum externum right lower eyelid)
• H00.013 (Hordeolum externum right eye, unspecified eyelid)
• H00.014 (Hordeolum externum left upper eyelid)
• H00.015 (Hordeolum externum left lower eyelid)
• H00.016 (Hordeolum externum left eye, unspecified eyelid)
• H00.019 (Hordeolum externum unspecified eye, unspecified eyelid).

Documentation

Practitioners should already be including the affected eye and eyelid in your documentation, but if you don’t do that, now is the time to start. This will help you select the most appropriate code as you attempt to capture the additional anatomical information that ICD-10 requires.

On your superbill, after “stye,” list the available options to prompt the physician to enter this information. A condensed system could include:

H00.01x (Hordeolum externum…)

CHOOSE ONE: LEFT EYE      RIGHT EYE

CHOOSE ONE: LOWER LID      UPPER LID

If the practitioner marks that the patient has a stye, he should also circle whether the left or right eye is affected, and whether the condition is present on the lower or upper lid.