ICD-10: H35.152

ICD-10 code H35.152 refers to "Retinopathy of prematurity, stage 4, left eye." This condition is characterized by significant retinal damage in premature infants, specifically at stage 4, which indicates a subtotal retinal detachment. Here are the clinical details associated with this diagnosis:

• Definition: Retinopathy of prematurity (ROP) is a potentially blinding condition that affects premature infants, particularly those with low birth weight. It involves abnormal growth of blood vessels in the retina, which can lead to scarring and retinal detachment.

• Stage 4 Classification: In the context of ROP, stage 4 is divided into two subcategories:

• Stage 4A: Partial retinal detachment.

• Stage 4B: Total retinal detachment. The designation of H35.152 specifically refers to the left eye being affected by stage 4 of this condition.

• Symptoms: Infants with stage 4 ROP may not exhibit obvious symptoms, but potential signs include:

• Poor visual response.
• Abnormal eye movements.

• Strabismus (crossed eyes).

• Diagnosis: Diagnosis is typically made through a comprehensive eye examination, often performed by a pediatric ophthalmologist. This examination may include:

• Fundus examination to assess the retina.

• Imaging techniques to evaluate the extent of retinal detachment.

• Treatment Options: Management of stage 4 ROP may involve:

• Surgical intervention to repair the retina, such as scleral buckling or vitrectomy.

• Ongoing monitoring and follow-up care to assess visual development and potential complications.

• Prognosis: The prognosis for infants with stage 4 ROP can vary. Early detection and treatment are crucial for improving visual outcomes. However, the risk of long-term visual impairment remains significant.

This classification is part of a broader system used to categorize various eye disorders, and it is essential for billing, coding, and treatment planning in clinical settings [12][10].

Retinopathy of prematurity (ROP) is a significant condition affecting premature infants, and stage 4 represents a severe form of the disease. The clinical presentation, signs, symptoms, and patient characteristics associated with ICD-10 code H35.152 (Retinopathy of prematurity, stage 4, left eye) include the following:

Clinical Presentation

• Severity: Stage 4 ROP indicates partial retinal detachment. This stage is critical as it can lead to significant visual impairment or blindness if not managed appropriately.
• Timing: Symptoms typically present in infants who are born prematurely, particularly those with low birth weight or who have received oxygen therapy.

Signs

• Retinal Abnormalities: Examination may reveal abnormal blood vessel growth in the retina, which can lead to scarring and detachment.
• Visual Disturbances: Infants may exhibit signs of visual impairment, such as lack of visual tracking or response to visual stimuli.

Symptoms

• Peripheral Vision Disturbances: Infants may show signs of peripheral vision issues, which can manifest as unusual head movements or lack of response to objects outside their direct line of sight.
• Flashes or Floaters: Although infants may not verbally express these symptoms, caregivers might notice signs of discomfort or unusual eye movements that could suggest the presence of flashes or floaters.

Patient Characteristics

• Demographics: Typically affects premature infants, particularly those born before 32 weeks of gestation or with a birth weight of less than 1500 grams.
• Risk Factors: Other risk factors include oxygen therapy, sepsis, and other complications associated with prematurity.

Monitoring and Management

• Regular Screening: Infants at risk for ROP should undergo regular eye examinations to monitor the progression of the disease.
• Intervention: Treatment options may include laser therapy or surgical intervention to address retinal detachment and prevent further vision loss.

Understanding these aspects of ROP, particularly at stage 4, is crucial for timely intervention and management to preserve vision in affected infants [3][10][11].

The ICD-10 code H35.152, which refers to "Retinopathy of prematurity, stage 4, left eye," has several alternative names and related terms. These include:

• Left retinopathy of prematurity stage 4: This term emphasizes the condition affecting the left eye specifically.
• Subtotal retinal detachment: This term describes the severity of the condition, indicating that there is a partial detachment of the retina in the left eye.
• Retinopathy of prematurity, stage 4: A more general term that can apply to either eye but is specifically coded as H35.152 for the left eye.

These alternative names help in understanding the condition and its implications in clinical settings, particularly in documentation and coding for medical records [10][12].

The diagnosis of Retinopathy of Prematurity (ROP), specifically for ICD-10 code H35.152, which refers to stage 4 in the left eye, is based on several clinical criteria and findings. Here are the key points regarding the diagnosis:

• Definition of Stage 4: Stage 4 of retinopathy of prematurity is characterized by subtotal retinal detachment. This means that there is a significant detachment of the retina, but it is not complete [1][14].

• Clinical Examination: Diagnosis typically involves a thorough examination of the retina using specialized equipment. This may include indirect ophthalmoscopy to assess the extent of retinal detachment and other changes associated with ROP [1].

• Gestational Age: Infants at higher risk for developing ROP, particularly stage 4, are those born prematurely, especially those with a gestational age of less than 29.5 weeks [11][13].

• Other Risk Factors: Additional risk factors include the presence of posterior zone 1 disease and preretinal hemorrhages, which can contribute to the severity of the condition [11][13].

• ICD-10 Classification: The ICD-10 code H35.152 is specifically designated for cases of retinopathy of prematurity at stage 4 in the left eye, indicating that it is a billable code used for medical classification and billing purposes [5][9].

In summary, the diagnosis of H35.152 involves recognizing the clinical signs of stage 4 ROP, assessing risk factors related to prematurity, and utilizing appropriate diagnostic tools to evaluate the condition of the retina.

Retinopathy of prematurity (ROP) is a serious eye condition that affects premature infants, and stage 4 indicates a significant level of severity, often involving retinal detachment. The standard treatment approaches for ROP, particularly for stage 4 in the left eye (ICD-10 code H35.152), typically include the following:

1. Laser Therapy

• Purpose: To ablate the peripheral retina and prevent further progression of the disease.
• Method: Laser photocoagulation is performed to target areas of the retina that are at risk of detachment.

2. Cryotherapy

• Purpose: Similar to laser therapy, cryotherapy is used to treat the peripheral retina.
• Method: This involves freezing the peripheral retina to induce scarring, which can help stabilize the retina.

3. Surgical Intervention

• Vitrectomy: In cases where there is significant retinal detachment, a vitrectomy may be performed. This surgery involves removing the vitreous gel from the eye to allow for better access to the retina.
• Scleral Buckling: This procedure involves placing a band around the eye to help support the retina and prevent further detachment.

4. Intravitreal Injections

• Anti-VEGF Therapy: In some cases, injections of anti-vascular endothelial growth factor (anti-VEGF) medications may be used to reduce abnormal blood vessel growth associated with ROP.

5. Monitoring and Follow-Up

• Regular Eye Exams: Continuous monitoring through regular eye examinations is crucial to assess the progression of the disease and the effectiveness of treatments.

6. Supportive Care

• Nutritional Support: Ensuring that the infant receives adequate nutrition can help in overall development and recovery.
• Oxygen Therapy: Careful management of oxygen levels is important, as fluctuations can exacerbate ROP.

These treatment approaches are tailored to the individual needs of the infant and depend on the specific characteristics of the ROP. Early detection and intervention are critical in managing the condition effectively to prevent vision loss.