ICD-10: H26.11

The diagnosis for ICD-10 code H26.11, which refers to localized traumatic opacities, involves specific criteria that must be met during the ophthalmologic evaluation. Here are the key points regarding the diagnostic criteria:

• Primary Diagnosis Requirement: The physician performing the preoperative ophthalmologic evaluation must establish a primary diagnosis of cataract. This is essential for the correct coding and classification of the condition [2].

• Specific Codes for Localized Traumatic Opacities: The H26.11 code is part of a group that includes various specific codes for localized traumatic opacities, which are categorized based on the eye affected. For instance:

• H26.111 refers to localized traumatic opacities in the right eye.
• H26.112 refers to localized traumatic opacities in the left eye.

• H26.113 refers to localized traumatic opacities that are bilateral [3][5].

• Clinical Evaluation: The diagnosis typically requires a thorough clinical evaluation, which may include a detailed history of the eye injury, visual acuity tests, and imaging studies to assess the extent of the opacities and their impact on vision [4].

• Documentation of Eye Injury: It is crucial that the medical encounter includes documentation of the eye injury, as this supports the diagnosis of localized traumatic opacities and justifies the use of the specific ICD-10 code [7].

These criteria ensure that the diagnosis is accurate and that the appropriate treatment and coding are applied for patients with localized traumatic opacities.