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H16.241

Billable

Ophthalmia nodosa, right eye

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

What This Code Means

Ophthalmia nodosa is an eye inflammation caused by contact with caterpillar hairs or similar irritating substances, resulting in small nodules on the eye surface. This code specifically refers to this condition affecting the right eye.

Coding Tips

  • Verify laterality is documented in the medical record before assigning this code; if bilateral, assign separate codes for each eye (H16.241 for right, H16.242 for left)
  • Document the causative agent (caterpillar hairs, plant material, etc.) in the medical record when possible, as this may support medical necessity and help with clinical correlation

Code Hierarchy

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