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H16.009

Billable

Unspecified corneal ulcer, unspecified eye

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A corneal ulcer is an open sore on the clear front surface of the eye (cornea), but the specific cause and which eye is affected are not documented. This condition can cause eye pain, redness, and vision problems if left untreated.

Coding Tips

  • Query the provider to determine the laterality (right eye, left eye, or bilateral) to assign the appropriate 7th character, as 'unspecified eye' may not meet documentation specificity requirements for optimal coding
  • If the underlying cause of the ulcer is documented (such as infection, trauma, or contact lens-related), consider coding the specific type of corneal ulcer (H16.00-H16.39) rather than the unspecified code

Code Hierarchy

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