Health Information Management

ICD-10 Trainer: Beware the bright lights of Vegas

CDI Strategies, May 22, 2014

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The Association of Clinical Documentation Improvement Specialists (ACDIS) conference attendees descended on Sin City for the 7th Annual ACDIS Conference. And while what happens in Vegas might stay in Vegas, our friends kindly provided us with their charts to code.

First up is fearless ACDIS director Brian. He’s a popular guy at the conference. You can even get your picture taken with him. Apparently a few too many “fans” showed up for the photo shoot and Brian is suffering from temporary blindness caused by excessive camera flashes.

According to his chart, Brian suffered from subjective transient vision loss bilaterally. If we look up Blindness, transient, in the ICD-10-CM Alphabetic Index, we are directed to Disturbance, vision, subjective, loss, transient and code H53.12-.

That dash tells us we need an additional character. When we head to the Tabular List, we find four codes:

  • H53.121, transient visual loss, right eye
  • H53.122, transient visual loss, left eye
  • H53.123, transient visual loss, bilateral
  • H53.129, transient visual loss, unspecified eye

We also find two separate Excludes1 notes. Under subcategory H53.1 (subjective visual disturbances), we find:

  • Excludes1: Subjective visual disturbances due to vitamin A deficiency (E50.5) visual hallucinations (R44.1) That means we cannot report E50.5 or R44.1 with any of the codes in subcategory H53.1.
  • Under H53.12 (transient visual loss) we find Excludes1: amaurosis fugax (G45.3-). Again, we can’t report any code from G45.3- with any code from H53.12-. They are mutually exclusive. If we were using a code from a different subcategory, say H53.13 (sudden visual loss), we could report a code from G45.3-. The Excludes1 note does not apply.

Fortunately for Brian, his condition is temporary and resolves without medical intervention. He just needs to stay away from the mob of camera-wielding fans.

Editor’s Note: Leppert is a senior managing editor for, and creator of the ICD-10 Trainer Blog. To read more her “made-up” mishaps and how to code them using ICD-10 visit

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