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H52.4
ICD-10-CM
Presbyopia

Understanding presbyopia diagnosis, treatment, and management? Find information on presbyopia ICD-10 code (H52.4), clinical documentation requirements, symptoms (blurred near vision, eye strain), and treatment options (reading glasses, bifocals, progressive lenses, surgery). Learn about presbyopia diagnosis criteria, age-related vision changes, and coding best practices for healthcare professionals. Explore resources on near vision correction, refractive errors, and ophthalmology medical coding.

Also known as

Accommodative insufficiency
Under-accommodation

Diagnosis Snapshot

Key Facts
  • Definition : Age-related vision loss affecting near focus.
  • Clinical Signs : Blurred near vision, difficulty reading small print, eye strain.
  • Common Settings : Primary care, ophthalmology, optometry clinics.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC H52.4 Coding
H52.4

Presbyopia

Impaired near vision due to aging.

H52.0-H52.9

Refractive errors

Vision problems caused by the eye's inability to focus light properly.

H50-H59

Disorders of eye and adnexa

Includes various eye conditions affecting vision and surrounding structures.

Code-Specific Guidance

Decision Tree for

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

Is the diagnosis presbyopia?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Farsightedness due to aging
Hyperopia (Farsightedness)
Astigmatism

Documentation Best Practices

Documentation Checklist
  • Presbyopia diagnosis documented
  • Near vision impairment details
  • Distance vision acuity recorded
  • Accommodative amplitude measured
  • Refractive error assessment noted

Coding and Audit Risks

Common Risks
  • Unspecified Presbyopia

    Coding H52.4 without laterality (right, left, bilateral) or combination status leads to rejected claims and inaccurate data.

  • Age-Related Macular Degeneration

    Incorrectly coding AMD (H35.3) with presbyopia (H52.4) when both exist requires distinct ICD-10 codes for each condition.

  • Unbundling Refractive Errors

    Billing presbyopia correction separately (e.g., eyeglasses) when included in an exam can trigger audits for improper billing practices.

Mitigation Tips

Best Practices
  • Annual eye exams after 40: ICD-10 H52.4, CPT 92004
  • Document near vision difficulty: CDI best practice
  • Refraction testing: CPT 92015, improves coding accuracy
  • Consider multifocal lenses: ICD-10 Z97.31, clear documentation
  • Patient education on presbyopia: improves compliance

Clinical Decision Support

Checklist
  • Verify age >40: Document declining near vision.
  • Confirm near vision difficulty: Test with near vision chart.
  • Assess refractive error: Rule out other eye conditions.
  • Document symptoms onset and impact on daily activities.

Reimbursement and Quality Metrics

Impact Summary
  • Presbyopia reimbursement: Maximize revenue with accurate ICD-10 H52.4 coding, optimize claims for vision care plans.
  • Coding accuracy: Proper CPT, HCPCS coding for presbyopia exams, treatments (e.g., eyeglasses, refractive surgery) impacts payments.
  • Quality metrics: Presbyopia diagnosis data crucial for eye care quality reporting, population health management initiatives.
  • Hospital reporting: Presbyopia statistics influence resource allocation, service development in ophthalmology departments.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code H52.4 for presbyopia
  • ICD-10 H52.4, document near vision difficulty
  • Document age-related vision changes for H52.4
  • Confirm decreased accommodation for presbyopia diagnosis
  • Near vision charts support H52.4 coding

Documentation Templates

Patient presents with complaints consistent with presbyopia, including blurry near vision, difficulty reading small print, and eye strain, particularly during close-up tasks.  Onset is gradual and age-related, consistent with the typical presentation of age-related farsightedness.  Symptoms impact the patient's ability to perform near vision activities such as reading and computer work.  Distant vision remains clear.  Examination reveals reduced near visual acuity, improved with plus lens correction.  Accommodation is decreased, confirming the diagnosis of presbyopia.  No other ocular pathologies were noted.  Diagnosis: Presbyopia (ICD-10: H52.4).  Treatment plan includes refractive correction with reading glasses, bifocals, multifocal lenses, or contact lenses.  Patient education provided regarding the progressive nature of presbyopia and the need for periodic adjustments to the prescription.  Follow-up recommended as needed for prescription adjustments and to monitor for any other age-related eye conditions.  Patient understands the diagnosis, treatment options, and plan of care.