In the intricate world of medical diagnostics, the H25.11 Diagnosis Code plays a crucial role in classifying age-related health conditions. Specifically, H25.11 is a part of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and it pinpoints a very specific eye condition: Age-related nuclear cataract in the right eye. Understanding these codes is essential for navigating medical records and ensuring accurate categorization of health issues.
Understanding H25.11: Age-Related Nuclear Cataract, Right Eye
The code H25.11 is designated as a billable/specific ICD-10-CM code. This means it’s not just for general classification; it’s precise enough to be used for reimbursement purposes in healthcare billing. If a medical diagnosis is “Age-related nuclear cataract, right eye,” then H25.11 is the code to use for adult patients (aged 15-124 years). It’s important to note that the current version, ICD-10-CM H25.11 2025, became effective on October 1, 2024, and is the standard for diagnoses from that date forward. While this is the US version, international versions of ICD-10 H25.11 might have slight variations.
Key Details of the H25.11 Code
There are specific ICD-10-CM coding rules associated with H25.11. Notably, it is applicable only to adult patients within the age range of 15 to 124 years. This age specificity is crucial for accurate code application.
Furthermore, within the ICD-10-CM system, H25.11 can have annotation back-references. These references link H25.11 to other codes that contain important annotations such as “Applicable To,” “Code Also,” “Code First,” or “Excludes” notes. These annotations provide additional context and guidelines for using the code correctly in different clinical scenarios.
To further clarify the meaning of H25.11, several approximate synonyms are used interchangeably with “Age-related nuclear cataract, right eye.” These include:
- Age related right nuclear cataract
- Age-related nuclear cataract of right eye
- R age related nuclear cataract
- Right age related nuclear cataract
- Right brunescent cataract
These synonyms help in recognizing the same condition described in slightly different terms, all pointing to the same H25.11 diagnosis code.
H25.11 in the ICD-10-CM Hierarchy and History
Within the broader diagnostic framework, ICD-10-CM H25.11 is categorized within specific Diagnostic Related Groups (MS-DRG v42.0). This grouping is relevant for hospital reimbursement and statistical analysis of medical conditions.
Looking at the code history, H25.11 was introduced in 2016 (effective October 1, 2015) as a new code in the non-draft ICD-10-CM. Since then, from 2017 through 2025, the code has remained unchanged, indicating its established and consistent use within the medical coding system.
Adjacent codes to H25.11 provide further context within the ICD-10-CM structure. For instance, H25.10 is for “Age-related nuclear cataract, unspecified eye,” H25.12 is for the “left eye,” and H25.13 is for “bilateral” cases. These related codes highlight the specificity of H25.11 to the right eye and its place within a family of codes detailing different types and locations of age-related cataracts.
Understanding diagnosis codes like H25.11 is vital for accurate medical documentation, billing, and data analysis in healthcare. This specific code clearly defines age-related nuclear cataract in the right eye, ensuring precise communication and record-keeping in medical settings.
