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H34.839
ICD-10-CM
Branch Retinal Vein Occlusion

Understanding Branch Retinal Vein Occlusion (BRVO): Find information on BRVO diagnosis, retinal vein occlusion symptoms, and treatment options. This resource covers clinical documentation for BRVO, including medical coding and healthcare best practices for managing this eye condition. Learn about the causes, risk factors, and latest advancements in BRVO care.

Also known as

BRVO
Retinal Vein Occlusion

Diagnosis Snapshot

Key Facts
  • Definition : Blockage of a retinal vein, causing retinal swelling and bleeding.
  • Clinical Signs : Sudden painless vision loss or blurring, often in one eye. May see retinal hemorrhages on exam.
  • Common Settings : Ophthalmology or optometry clinics, retinal specialist.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC H34.839 Coding
H34.83

Other retinal vascular occlusions

Covers branch retinal vein occlusion (BRVO).

H34

Disorders of retinal vessels

Includes various retinal vascular conditions like occlusions.

H00-H59

Diseases of the eye and adnexa

Encompasses all eye-related disorders including retinal issues.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the BRVO unilateral or bilateral?

  • Unilateral

    Is the BRVO major branch?

  • Bilateral

    Is the BRVO major branch in both eyes?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Blockage of a retinal vein branch.
Blockage of the central retinal vein.
Hemorrhage in the vitreous gel of the eye.

Documentation Best Practices

Documentation Checklist
  • Document laterality (right, left, bilateral)
  • BRVO type (major, macular, hemiretinal)
  • Presence/absence of macular edema
  • Visual acuity measurements
  • Describe any neovascularization

Coding and Audit Risks

Common Risks
  • Laterality Coding

    Missing or incorrect laterality (right, left, bilateral) for BRVO can lead to inaccurate billing and claims rejection.

  • BRVO vs. CRVO

    Miscoding BRVO as the more severe central retinal vein occlusion (CRVO) or vice versa impacts reimbursement and quality metrics.

  • Underlying Cause

    Failure to document and code underlying conditions like hypertension or diabetes associated with BRVO can affect risk adjustment and resource allocation.

Mitigation Tips

Best Practices
  • Control diabetes, hypertension via ICD-10 compliant charting for optimal BRVO management.
  • Timely ophthalmology referral, fluorescein angiography crucial for accurate BRVO diagnosis (ICD-10: H34.83).
  • Document BRVO severity, visual acuity for accurate HCC coding, improved risk adjustment (RAF).
  • Intravitreal injections, laser photocoagulation if indicated, with clear CDI documentation for compliance.
  • Monitor, document macular edema, neovascularization for proactive BRVO management, coding accuracy.

Clinical Decision Support

Checklist
  • Confirm decreased visual acuity or visual field defect documented.
  • Fundus exam confirms BRVO: dilated tortuous veins, retinal hemorrhages.
  • Assess for macular edema using OCT and/or fluorescein angiography.
  • Rule out other causes of retinal vascular occlusion (e.g., hypertension, diabetes).
  • Document BRVO laterality (right eye, left eye, or bilateral).

Reimbursement and Quality Metrics

Impact Summary
  • Branch Retinal Vein Occlusion (BRVO) reimbursement hinges on accurate ICD-10 coding (H34.81, H34.83) and documentation of laterality.
  • BRVO coding accuracy impacts hospital reporting for quality metrics related to vascular events and eye disease management.
  • Proper BRVO documentation supports appropriate evaluation and management (E/M) coding, maximizing reimbursement.
  • Timely diagnosis and treatment of BRVO, reflected in coding, positively affect quality of care metrics and patient outcomes.

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Frequently Asked Questions

Common Questions and Answers

Q: What are the key differential diagnoses to consider when a patient presents with suspected Branch Retinal Vein Occlusion (BRVO)?

A: When a patient presents with symptoms suggestive of BRVO, such as sudden painless vision loss or visual field defects, it's crucial to consider several differential diagnoses to ensure accurate management. These include other retinal vascular disorders like Central Retinal Vein Occlusion (CRVO), hemi-retinal vein occlusion, and ocular ischemic syndrome. Non-vascular conditions mimicking BRVO, such as diabetic retinopathy, hypertensive retinopathy, and retinal macroaneurysm, should also be ruled out. Distinguishing BRVO requires a thorough ophthalmic examination, including funduscopy, fluorescein angiography, and optical coherence tomography (OCT). Accurate differentiation is essential as treatment strategies vary depending on the underlying cause. Explore how OCT angiography can aid in differentiating BRVO from other retinal vascular pathologies.

Q: How do I determine the appropriate management strategy for a patient with Branch Retinal Vein Occlusion based on their individual presentation and risk factors?

A: Managing Branch Retinal Vein Occlusion (BRVO) requires a personalized approach based on the patient's specific presentation, including visual acuity, extent of macular edema, and the presence of neovascularization. Risk factors like hypertension, diabetes, and hyperlipidemia should also be carefully assessed and managed. Treatment options range from observation for mild cases without macular edema to intravitreal injections of anti-VEGF agents or corticosteroids for macular edema. In cases with neovascularization, panretinal photocoagulation may be necessary. The decision-making process should involve shared decision-making with the patient, considering their preferences and the potential risks and benefits of each treatment modality. Consider implementing a standardized assessment protocol for BRVO patients to ensure comprehensive evaluation and tailored management. Learn more about the latest evidence-based guidelines for BRVO treatment.

Quick Tips

Practical Coding Tips
  • Code H34.83 for BRVO
  • Document laterality (OD/OS)
  • Specify quadrant involved
  • Rule out other retinal issues
  • Consider underlying conditions

Documentation Templates

Patient presents with complaints consistent with branch retinal vein occlusion (BRVO).  Symptoms include blurred vision, visual field loss, or sudden painless vision changes in one eye.  The patient reports [Insert specific symptom onset and duration, e.g., "blurry vision in the right eye for two days"].  Ophthalmoscopic examination revealed [Insert specific findings, e.g., retinal hemorrhages, dilated and tortuous veins, cotton wool spots] in the [Insert affected quadrant, e.g., superotemporal quadrant] consistent with a BRVO diagnosis.  Differential diagnoses considered include central retinal vein occlusion (CRVO), hemi-retinal vein occlusion, and ocular ischemic syndrome.  Fluorescein angiography (FA) is planned to confirm the diagnosis and assess macular ischemia.  Intravitreal injections of anti-VEGF medication may be considered depending on the presence and severity of macular edema.  Optical coherence tomography (OCT) will be performed to evaluate retinal thickening.  Patient education provided on BRVO, risk factors including hypertension, diabetes, and hyperlipidemia, and the importance of follow-up care.  The patient will return for repeat OCT and visual acuity testing in [Insert timeframe, e.g., two weeks] to monitor disease progression and treatment response.  ICD-10 code H34.831 (branch retinal vein occlusion, right eye) or H34.832 (branch retinal vein occlusion, left eye) is appropriate, depending on laterality confirmed during fluorescein angiography.  CPT codes for the diagnostic evaluation and potential treatment will be determined and documented following the procedures.  The patient understands the plan of care and agrees to follow-up.