Murder by fake drugs Time for international action

Murder by fake drugs Time for international action

Are we just going to publish such stories and do nothing in action?
 When I was a medical Student 3 decades ago one of my friends owned  a medical Store in Hyderabad
He would show me two tablets of a medicine which are exact looking copies and one was sold for 10 rupees and had the real drug and the other had chalk and sold for 2 rupees.

Unless we can really do something to curb this fake drug menace human life will be hanging by a thread.
 I suggest all the real drug manufacturers should band together and spend a portion of the  Billions of dollars they spend on marketing of medicines to fight this menace.

The Global Pharma Health Fund (GPHF)

only Merk is contributing to this \ let all others join

Paul N Newton, clinical lecturer
Centre for Tropical Medicine and Infectious Disease, Nuffield Department of Clinical Medicine, Oxford University, Oxford OX3 9DU (moc.liamtoh@001luapnotwen)
Nicholas J White, professor of tropical medicine
Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand (ht.ca.lodiham.dnomaid@wjnnf)
Jan A Rozendaal, malaria control adviser
Asian Development Bank - Intensified Communicable Disease Control Project, Ministry of Health, Jakarta, Indonesia
Michael D Green, chemist
Division of Parasitic Diseases, Center for Disease Control and Prevention, Atlanta, GA 30333, USA
Copyright and License information ► Disclaimer
This article has been cited by other articles in PMC.
Until recently the most infamous internationally known example of fake drug dealing was Graham Greene's fictional account of a British fake penicillin peddler who was eliminated in the sewers of postwar Vienna in The Third Man.1 Unfortunately, malevolent dealings in counterfeit drugs are very much a contemporary reality. Notorious recent real examples include neomycin eye drops and meningococcal vaccine made of tap water; paracetamol syrup made of industrial solvent; ampicillin consisting of turmeric; contraceptive pills made of wheat flour; and antimalarials, antibiotics, and snake antivenom containing no active ingredients.2–9

In a recent survey of pharmacies in the Philippines, 8% of drugs bought were fake (quoted by Wondemagegnehu2). A countrywide survey in Cambodia in 1999 showed that 60% of 133 drug vendors sampled sold, as the antimalarial mefloquine, tablets that contained the ineffective but much cheaper sulphadoxine-pyrimethamine, obtained from stocks that should have been destroyed, or fakes that contained no drug at all.3,4 In another recent survey, 38% of tablets sold in five countries in mainland South East Asia as the new antimalarial artesunate were fake.5 Artesunate is an extremely important antimalarial drug, and its rapid action and lack of side effects have created significant demand in endemic areas. These characteristics, along with a relatively high cost, make artesunate particularly attractive to counterfeiters, who have gone to great lengths to deceive patients, using small amounts of ineffectual bitter chloroquine, copying the blister pack design, and even providing fake holograms on the package.5 Some counterfeit drugs contain actively harmful ingredients, not just bogus placebos. For example, aspirin, thought to be an important contributor to acidosis in children with malaria10 and a cause of Reye's syndrome, has been used in the manufacture of fake chloroquine in Africa.6

Influx of fake drugs to Nigeria worries health experts.
Raufu A.
BMJ. 2002 Mar 23;324(7339):698. No abstract available.
PMID: 11909782 Free PMC Article
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Select item 1606284
3.
Counterfeit drugs: implications for health.
ten Ham M.
Adverse Drug React Toxicol Rev. 1992 Spring;11(1):59-65. No abstract available.
PMID: 1606284
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Select item 19374325
4.
Problems associated with substandard and counterfeit drugs in developing countries: a review article on global implications of counterfeit drugs in the era of antiretroviral (ARVs) drugs in a free market economy.
Nsimba SE.
East Afr J Public Health. 2008 Dec;5(3):205-10. Review.
PMID: 19374325
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Select item 19242667
5.
[Internet pharmacies and counterfeit drugs].
Schweim JK, Schweim HG.
Med Klin (Munich). 2009 Feb 15;104(2):163-9. doi: 10.1007/s00063-009-1027-5. German.
PMID: 19242667
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6.
New countermeasures considered as drug counterfeiting grows.
Schubert C.
Nat Med. 2008 Jul;14(7):700. doi: 10.1038/nm0708-700a. No abstract available.
PMID: 18607355
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7.
Counterfeiting and piracy of pharmaceuticals.
Grackin A.
IEEE Eng Med Biol Mag. 2008 Nov-Dec;27(6):66-9. doi: 10.1109/MEMB.2008.929891. No abstract available.
PMID: 19004698
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8.
Pharmaceutical counterfeiting.
Deisingh AK.
Analyst. 2005 Mar;130(3):271-9. Epub 2004 Dec 14. Review.
PMID: 15724152
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Select item 16497756
9.
WHO to set up international task force on counterfeit drugs.
Zarocostas J.
BMJ. 2006 Feb 25;332(7539):444. No abstract available.
PMID: 16497756 Free PMC Article
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Select item 20376036
10.
Beef up international cooperation on counterfeits.
Shepherd M.
Nat Med. 2010 Apr;16(4):366. doi: 10.1038/nm0410-366.
PMID: 20376036
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Select item 1606281
11.
Counterfeit medicines--the case for action.
Volans GN.
Adverse Drug React Toxicol Rev. 1992 Spring;11(1):3. No abstract available.
PMID: 1606281
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12.
Co-proxamol (distalgesic) procurement in Bahrain. Policy implications for Gulf Cooperation Council countries.
Al Khaja KA, Sequeira RP, Damanhori AH.
Med Princ Pract. 2009;18(3):253-4. doi: 10.1159/000204361. Epub 2009 Apr 6. No abstract available.
PMID: 19349733 Free Article
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13.
Fake prescription drugs are flooding the United States.
Charatan F.
BMJ. 2001 Jun 16;322(7300):1443. No abstract available.
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14.
Fake AIDS drugs found.
[No authors listed]
AIDS Patient Care STDS. 2001 Aug;15(8):446. No abstract available.
PMID: 11526945
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15.
WHO's response to international drug control treaties.
Khan I.
NIDA Res Monogr. 1981 Feb;34:64-7. No abstract available.
PMID: 6783954
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16.
International challenge of drug abuse: a perspective from the United Nations.
Ling GM, Gomez del Prado J.
NIDA Res Monogr. 1978;(19):60-8. No abstract available.
PMID: 106300
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17.
Russia cracks down on counterfeit drugs.
Parfitt T.
Lancet. 2006 Oct 28;368(9546):1481-2. No abstract available.
PMID: 17078121
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18.
The war against drugs. II. Why the war against drugs has failed.
Wodak A.
Med J Aust. 1991 Jul 1;155(1):37-8. No abstract available.
PMID: 2067433
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19.
Knockoffs on the pharmacy shelf.
Pasternak D.
US News World Rep. 2001 Jun 11;130(23):26-7. No abstract available.
PMID: 11419218
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20.
Fake biotech drugs raise concerns.
Fox JL.
Nat Biotechnol. 2001 Jul;19(7):603. No abstract available.
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Most people who think they have a penicillin allergy are wrong. That’s dangerous.

Most people who think they have a penicillin allergy are wrong. That’s dangerous.

Penicillin was one of the first antibiotics. (Courtesy of the South Carolina Department of Health and Environmental Control)
By Kate Furby
August 10 at 6:00 AM
Email the author
Are you allergic to penicillin? If so, are you sure about that?

It’s surprisingly common for people to wrongly think they have a penicillin allergy — and that misconception can be dangerous for their health.

Ten percent of all patients in the United States claim to have a penicillin allergy. Of those people, 90 percent are not truly allergic and can tolerate the drug. That means millions of people take alternative antibiotics, which are more expensive and can put their health and potentially the health of others at risk. The solution is a simple allergy test.

A study in the British Medical Journal (BMJ) looked at six years’ worth of medical records for patients in the United Kingdom and found that those with a penicillin allergy had an almost 70 percent greater chance of acquiring a methicillin-resistant Staphylococcus aureus (MRSA) infection and a 26 percent increased risk of Clostridium difficile-related colitis (C. diff.). MRSA and C. diff. are major health risks worldwide. The study compared adults with a known penicillin allergy to similar people without a known penicillin allergy.


People labeled with a penicillin allergy are usually instead given broad-spectrum antibiotics, which may kill off more good bacteria along with the bad. This appeared to increase a patient’s risk of infection with MRSA or C. diff., which are common in our environment and can live without causing any problems on someone’s skin or gut. However, if a broad antibiotic kills off competing good bacteria, MRSA and C. diff. can thrive and start to cause problems.


Four spherical methicillin-resistant Staphylococcus aureus (MRSA) bacteria being engulfed by a blue-colored human white blood cell. (National Institute of Allergy and Infectious Diseases)
“Penicillin-related drugs, that whole class … they’re very effective at killing, and they’re very targeted. So for some bacteria they’re still the best. Oldie but goody,” said Kim Blumenthal, lead author of the new study and assistant professor of medicine at Harvard Medical School.

“I have seen so many terrible, terrible outcomes” from C. diff. infections, Blumenthal said, including serious diarrhea, sepsis and death.


“All of us need to understand that antibiotic use is not a free ride, it carries a lot of risk,” said Paul Sax, clinical director of infectious diseases at Brigham and Women’s Hospital. He was not involved in the study but he says the study adds to the “substantial body of evidence” which shows that a penicillin allergy has been linked to longer hospital stays and an increased risk of acquiring resistant infections.

Using non-targeted antibiotics can quickly breed resistant bacteria. “Not only is it harmful to the world and the general population . . . but it’s harmful to the individual patient. So the message to the public is that it could be dangerous to you or me,” said Helen Boucher, director of the Infectious Diseases Fellowship Program at Tufts Medical Center, who was not involved in the study.

“In antibiotic resistance we don’t have a very loud patient advocacy voice . . . and the reasons for that are complicated, but a lot of it has to do with the fact that a lot of the victims aren’t here to speak for themselves because they died,” Boucher said.


The infections are resistant to many known drugs and can quickly become life-threatening. According to the Centers for Disease Control and Prevention, 2 million people, equivalent to the approximate population of Brooklyn, are infected with resistant bacteria every year. At least 23,000 people die each year as a direct result and even more from complications.

Diagnosing penicillin allergies is challenging. Symptoms such as a rash, nausea or diarrhea could be a sign of allergy, or they might coincidentally occur when someone is taking antibiotics, according to Jonathan Grein, medical director at the Department of Hospital Epidemiology at Cedars Sinai Medical Center in Los Angeles. Children frequently get rashes that are mistaken for penicillin allergies, Blumenthal said.

Even if people are diagnosed correctly as children, they can grow out of an allergy, said Sax.


Which raises the question, what exactly is an allergy? The Internet is full of “answers,” as any late-night Googling hypochondriac can tell you, but an allergy is simply an exaggerated immune response triggered unnecessarily. It can be anything from a rash to trouble breathing.

“Part of the problem is that ‘allergy’ means different things to different people,” said Grein. “Making that distinction between these intolerances and side effects and life-threatening immediate allergic reaction, that’s where the challenge is.”

For example, a patient of Sax’s, in his mid-20s, had a life-threatening heart infection. Penicillin could save him, but his medical record said he was allergic to the drug. Careful questioning by his medical team was able to determine that although he had nausea and diarrhea while on penicillin, he did not have an allergy, Sax said. Knowing this, the hospital administered the appropriate penicillin antibiotic to save his life.


In the case of penicillin, it is important to know that the risks of the allergy diagnosis are sometimes worse than the symptoms of the allergy itself. In most cases, penicillin should only be avoided if the allergy is immediate and life-threatening.

“There are over 30 million Americans who have a penicillin allergy on their record. And there are things we can do,” Blumenthal said.

Examine your own medical record, Blumenthal said. “I would want patients to think, ‘Hmm, am I really allergic to penicillin, or did my mom just tell me and it’s not really true, and should I get that evaluated?’ ”

If it’s been more than 10 years since you were diagnosed, talk to your doctor about getting retested.

ICD-10-CM Code Q10.3 Other congenital malformations of eyelid

Ablatio ICD-10-CM Alphabetical Index

The ICD-10-CM Alphabetical Index is designed to allow medical coders to look up various medical terms and connect them with the appropriate ICD codes. There are 1 terms under the parent term 'Ablatio' in the ICD-10-CM Alphabetical Index.

 Ablatio

 retinae - see Detachment, retina 

ICD-10-CM Code Q10.3 
Other congenital malformations of eyelid

BILLABLE POA Exempt | ICD-10 from 2011 - 2016

Q10.3 is a billable ICD code used to specify a diagnosis of other congenital malformations of eyelid. A 'billable code' is detailed enough to be used to specify a medical diagnosis.

POA Indicators on CMS form 4010A are as follows:

Indicator	Meaning	CMS Will Pay CC/MCC DRG Costs
Y	Diagnosis was present at time of inpatient admission	Yes
N	Diagnosis was not present at time of inpatient admission	No
U	Documentation insufficient to determine if the condition was present at the time of inpatient admission.	No
W	Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission.	Yes
1	Exempt from POA reporting	No

---

The ICD code Q103 is used to code Coloboma

A coloboma (from the Greek koloboma, meaning defect,) is a hole in one of the structures of the eye, such as the iris, retina, choroid, or optic disc. The hole is present from birth and can be caused when a gap called the choroid fissure, which is present during early stages of prenatal development, fails to close up completely before a child is born. The classical description in medical literature is of a key-hole shaped defect. A coloboma can occur in one eye (unilateral) or both eyes (bilateral). Most cases of coloboma affect only the iris. People with coloboma may have no vision problems or may be blind, depending on severity. It affects less than one in every 10,000 births.

Specialty:	Medical Genetics
MeSH Codes:	D003103, D003103, D003103, D003103, D003103
ICD 9 Codes:	377.23, 743.4, 743.46, 743.52, 743.57

Source: Wikipedia

Coding Notes for Q10.3 Info for medical coders on how to properly use this ICD-10 code

Inclusion Terms:

Ablepharon

Blepharophimosis, congenital

Coloboma of eyelid

Congenital absence or agenesis of cilia

Congenital absence or agenesis of eyelid

Congenital accessory eyelid

Congenital accessory eye muscle

Congenital malformation of eyelid NOS

MS-DRG Mapping

• DRG Group #124-125 - Other disorders of the eye with MCC.

• DRG Group #124-125 - Other disorders of the eye without MCC.

Related Concepts SNOMET-CT

• Congenital scleral show (finding)

ICD-10-CM Alphabetical Index References for 'Q10.3 - Other congenital malformations of eyelid'

The ICD-10-CM Alphabetical Index links the below-listed medical terms to the ICD code Q10.3. Click on any term below to browse the alphabetical index.

Narrowness, abnormal, eyelid (Q10.3)

Epiblepharon(congenital) (Q10.3)

Epicanthus, epicanthic fold(eyelid) (congenital) (Q10.3)

Ablepharia, ablepharon (Q10.3)

Symblepharon +

Absence(of) (organ or part) (complete or partial) +

Excess, excessive, excessively +

Fold, folds(anomalous) (see: Anomaly, by site) +

Coloboma(iris) +

Anomaly, anomalous(congenital) (unspecified type) +

Agenesis +

Imperfect +

Ankyloblepharon(eyelid) (acquired)(see: Blepharophimosis) +

Atrophy, atrophic(of) +

Accessory(congenital) +

Blepharophimosis(eyelid) +

Insufficiency, insufficient +

Deformity +

Malformation(congenital) (see: Anomaly) +

Hypoplasia, hypoplastic +

101 visual disturbances

Code

Description

H53.142

Visual discomfort, left eye

icd10cm

H53.143

Visual discomfort, bilateral

icd10cm

H53.141H53.149

Visual discomfort, unspecified

icd10cm

H53.131

Sudden visual loss, right eye

icd10cm

H53.10

Unspecified subjective visual disturbances

icd10cm

H53.123

Transient visual loss, bilateral

icd10cm

H53.132

Sudden visual loss, left eye

icd10cm

H53.133

Sudden visual loss, bilateral

icd10cm

H53.14

Visual discomfort

icd10cm

H53.149Visual discomfort, unspecifiedicd10cmH53.142Visual discomfort, left eyeicd10cmH53.143Visual discomfort, bilateralicd10cmH53.131Sudden visual loss, right eyeicd10cmCopyH53.10Unspecified subjective visual disturbancesicd10cmH53.123Transient visual loss, bilateralicd10cmH53.132Sudden visual loss, left eyeicd10cmH53.133Sudden visual loss, bilateralicd10cmH53.14Visual discomforticd10cmH53.141Visual discomfort, right eyeicd10cmH53.141

Visual discomfort, right eye

icd10cm

Diagnosis Index entries containing back-references to H53.15:

• Distortion(s) (congenital)
  • visual - see also Disturbance, vision
    • shape and size H53.15
• Disturbance(s) - see also Disease
  • vision, visual H53.9
    • subjective H53.10
      • distortions of shape and size H53.15
• Macropsia H53.15
• Megalopsia H53.15
• Metamorphopsia H53.15
• Micropsia H53.15

The following code(s) above H53.15 contain annotation back-references

 that may be applicable to H53.15:

• H00-H59 
   Diseases of the eye and adnexa
• H53.1 
   Subjective visual disturbances

Approximate Synonyms

• Bilateral metamorphopsia
• Bilateral metamorphopsia (eye condition)
• Left metamorphopsia
• Left metamorphopsia (eye condition)
• Metamorphopsia
• Metamorphopsia (eye condition)
• Right metamorphopsia
• Right metamorphopsia (eye condition)

ICD-10-CM H53.15 is grouped within Diagnostic Related Group(s) (MS-DRG v35.0):

• 124 Other disorders of the eye with mcc
• 125 Other disorders of the eye without mccH53.141
• 
  
• 
  
• H53.149
• Visual discomfort, unspecified
• icd10cm
• H53.142
• Visual discomfort, left eye
• icd10cm
• H53.143
• Visual discomfort, bilateral
• icd10cm
• H53.131
• Sudden visual loss, right eye
• icd10cm
• H53.10
• Unspecified subjective visual disturbances
• icd10cm
• H53.123
• Transient visual loss, bilateral
• icd10cm
• H53.132
• Sudden visual loss, left eye
• icd10cm
• H53.133
• Sudden visual loss, bilateral
• icd10cm
• H53.14
• Visual discomfort
• icd10cm
• H53.141
• Visual discomfort, right eye
• icd10cm
• 
  
• H53.149
• Visual discomfort, unspecified
• icd10cm
• Copy
• H53.142
• Visual discomfort, left eye
• icd10cm
• H53.143
• Visual discomfort, bilateral
• icd10cm
• H53.131
• Sudden visual loss, right eye
• icd10cm
• H53.10
• Unspecified subjective visual disturbances
• icd10cm
• H53.123
• Transient visual loss, bilateral
• icd10cm
• H53.132
• Sudden visual loss, left eye
• icd10cm
• H53.133
• Sudden visual loss, bilateral
• icd10cm
• H53.14
• Visual discomfort
• icd10cm
• H53.141
• Visual discomfort, right eye
• icd10cm

Systemic Conditions

Refractive Disorders

Diagnosis ICD-9 Code ICD-10 Code

AIDS/HIV 42 B20

Diabetes, Type 1 (no manifestations) 250.01 E10.9

Diabetes, Type 1 (with manifestations) 250.51 E10.3

Diabetes, Type 2 (no manifestations) 250.00 E11.9

Diabetes, Type 2 (with manifestations) 250.50 E11.3

Giant cell arteritis (other) 446.5 M31.6

Giant cell arteritis (with polymyalgia rheumatica) M31.5

Hyperlipidemia 272.4 E78.5

Hypertension 401.9 I10

Lupus 710.0 M32.10

Metastasis to eye (any cancer, any part of eye) 198.4 C79.49

Mycobacteria infection 31.9 A31.9

Rheumatoid arthritis 714.0 M06.9

Sarcoidosis 135 D86.9

Sleep apnea 780.57 G47.30

Syphilis 97.9 A53.9

Thyroid (Thyroid Eye Disease) 246.9 E07.9

Tuberculosis (primary) 10.00 A15.7

Wegener’s granulomatosis 446.4 M31.30

Diagnosis ICD-9

Code

ICD-10 Code

Right Eye Left Eye Bilateral

Aniseikonia 367.32 H52.32

Anisometropia 367.31 H52.31

Astigmatism, irregular 367.22 H52.211 H52.212 H52.213

Astigmatism, regular 367.21 H52.221 H52.222 H52.223

Hyperopia 367.0 H52.01 H52.02 H52.03

Myopia 367.1 H52.11 H52.12 H52.13

Myopic degeneration (progressive high myopia) 360.21 H44.21 H44.22 H44.23

Presbyopia 367.4 H52.4

Transient refractive change 367.81 H52.6

General Eye-Related Codes

Diagnosis ICD-9

Code

ICD-10 Code

Right Eye Left Eye Bilateral

Color deficiency: Achromatopsia H53.51

Color deficiency: Acquired color vision deficiency H53.52

Color deficiency: Deuteranomaly H53.53

Color deficiency: Protanomaly H53.54

Color deficiency: Tritanomaly H53.55

Day blindness (hemeralopia) H53.11

Diplopia 368.2 H53.2

Glare sensitivity H53.71

Impaired contrast sensitivity H53.72

Night blindness (nyctalopia): Abnormal dark adaptation curve H53.61

Night blindness (nyctalopia): Acquired night blindness H53.52

Night blindness (nyctalopia): Congenital night blindness H53.63

Night blindness (nyctalopia): Other night blindness H53.69

Other ill-defined disorders of eye 379.99 H57.8

Other visual distortions and entoptic phenomena 368.15 H53.19

Pain in or around eye 379.91 H57.11 H57.12 H57.13

Psychophysical visual disturbances (agnosia, prosopagnosia,

hallucinations, Balint syndrome, Riddoch phenomenon) 368.16 H53.16

Redness or discharge of eye 379.93 H57.8

Subjective visual disturbances (unspecified) 368.10 H53.10

Sudden visual loss 368.11 H53.131 H53.132 H53.133

Swelling or mass of eye 379.92 H57.8

Transient visual loss (includes scintillating scotoma) 368.12 H53.121 H53.122 H53.123

Visual discomfort (asthenopia) 368.13 H53.141 H53.142 H53.143

Visual distortions of shape and size (metamorphopsia,

macropsia, micropsia) 368.14 H53.15

Visual disturbance, other 368.9 H53.19

Neurologic Conditions

Diagnosis ICD-9 Code ICD-10 Code

Amaurosis fugax G45.3

Brain tumor 239.6 D49.6

Cerebral artery aneurysm (nonruptured) I67.1

Cerebral artery dissection (nonruptured) I67.0

Cerebral venous thrombosis (nonpyogenic) I67.6

Chiari malformation, type 1 348.4 G93.5

Chronic inflammatory demyelinating polyneuritis G61.81

Craniopharyngioma D35.3

Dizziness 780.4 R42

Guillain-Barre syndrome (acute inflammatory demyelinating polyneuritis) G61.0

Guillain-Barre syndrome (sequelae - cranial nerve palsy, intracranial HTN) G65.0

Hypertensive encephalopathy I67.4

Moyamoya disease I67.5

Multiple sclerosis 340 G35

Myasthenia gravis without exacerbation 358.00 G70.00

Myasthenia gravis with (acute) exacerbation 358.01 G70.01

Neuromyelitis optica 341.0 G36.0

Pituitary, benign neoplasm 227.3 D35.2

Pituitary, malignant neoplasm 194.3 C75.1

Pituitary, neoplasm of uncertain behavior 237.0 D44.3

Post-concussive syndrome 310.2 F07.81

Posterior reversible encephalopathy syndrome I67.83

Progressive vascular leukoencephalopathy I67.3

Pseudotumor cerebri (IIH) 348.2 G93.2

Stroke (acute, ill-defined cerebrovascular disease) 436 I67.81

Stroke (chronic) I67.82

Transient ischemic attack (TIA) 435.9 G45.8

Vertebrobasilar artery syndrome 435.3 G45.0

Headache and Facial Pain

Diagnosis ICD-9 Code ICD-10 Code

Headache 784.0 R51

Acute migraine, w/aura (isolated) 346.00 G43.109

Acute migraine, w/aura (intractable) 346.01 G43.119

Acute migraine, w/aura (isolated, status migrainosus) 346.02 G43.101

Acute migraine, w/aura (intractable, status migrainosus) 346.03 G43.111

Acute migraine, NO aura (isolated) 346.10 G43.009

Acute migraine, NO aura (intractable) 346.11 G43.019

Acute migraine, NO aura (isolated, status migrainosus) 346.12 G43.001

Acute migraine, NO aura (intractable, status migrainosus) 346.13 G43.011

Chronic migraine, NO aura (intermittent) G43.709

Chronic migraine, NO aura (intermittent, status migrainosus) G43.701

Chronic migraine, NO aura (intractable) G43.719

Chronic migraine, NO aura (intractable, status migrainosus) G43.711

Persistent migraine aura, no stroke, isolated 346.50 G43.509

Persistent migraine aura, no stroke, intractable 346.51 G43.519

Persistent migraine aura, no stroke, isolated headache, status migrainosus 346.52 G43.501

Persistent migraine aura, no stroke, intractable headache, status migrainosus 346.53 G43.511

Persistent migraine aura, with stroke, isolated headache 346.60 G43.609

Persistent migraine aura, with stroke, intractable headache 346.61 G43.619

Persistent migraine aura, with stroke, isolated headache, status migrainosus 346.62 G43.601

Persistent migraine aura, with stroke, intractable headache, status migrainosus 346.63 G43.611

Ophthalmoplegic migraine, isolated headache 346.20

Ophthalmoplegic migraine, intractable headache 346.21

Periodic headache syndrome in child or adult, not intractable G43.C0

Periodic headache syndrome in child or adult, intractable G43.C1

Post-herpetic trigeminal neuralgia B02.22

Trigeminal neuralgia 350.1 G50.0

Atypical facial pain 350.2 G50.1

Optic Neuropathies

Diagnosis ICD-9

Code

ICD-10 Code

Right Eye Left Eye Bilateral

Foster-Kennedy syndrome 377.04 H47.141 H47.142 H47.143

Hereditary optic neuropathy/atrophy (LHON & DOA) 377.16 H47.22

Ischemic optic neuropathy (NAION & AAION) 377.41 H47.011 H47.012 H47.013

Leptomeningeal carcinomatosis 198.4 C79.32

Neuroretinitis 363.05 H30.011 H30.012 H30.013

Nutritional optic neuropathy 377.33 H46.2

Optic atrophy, primary 377.11 H47.211 H47.212 H47.213

Optic atrophy, post-inflammatory 377.12 H47.291 H47.292 H47.293

Optic atrophy, associated with retinal dystrophies 377.13 H47.291 H47.292 H47.293

Optic atrophy, associated with glaucomatous cupping 377.14 H47.231 H47.232 H47.233

Optic atrophy, partial 377.15 H47.291 H47.292 H47.293

Optic nerve coloboma 377.23 H47.311 H47.312 H47.313

Optic neuropathy, NOS 377.49 H47.391 H47.392 H47.393

Optic nerve drusen 377.21 H47.321 H47.322 H47.323

Optic nerve hypoplasia 377.43 H47.031 H47.032 H47.033

Optic nerve sheath hematoma 377.42 H47.021 H47.022 H47.023

Optic neuritis (acute retrobulbar) 377.32 H46.11 H46.12 H46.13

Optic neuritis (meningococcal) 36.81 A39.82

Optic neuritis (other) 377.39 H46.8

Optic neuritis (syphilitic) 94.85 A52.15

Optic papillitis H46.01 H46.02 H46.03

Optic pit 377.22 H47.391 H47.392 H47.393

Papilledema, NOS 377.00 H47.10

Papilledema, associated with increased intracranial pressure 377.01 H47.11

Papilledema, associated with hypotony 377.02 H47.12

Papilledema, associated with retinal disorder 377.03 H47.13

Pseudopapilledema 377.24 H47.331 H47.332 H47.333

Toxic optic neuropathy 377.34 H46.3

Other disorders of optic nerve and visual pathways 377.9 H47.091 H47.092 H47.093

Pupil Abnormalities

Accommodative Disorders

Amblyopia

Chiasmal Disease

Diagnosis ICD-9

Code

ICD-10 Code

Right Eye Left Eye Bilateral

Adie’s tonic pupil 379.46 H57.51 H57.52 H57.053

Anisocoria 379.41 H57.02

Horner’s syndrome G90.2

Light-near dissociation (non-syphilitic) 379.45 H57.01

Light-near dissociation (syphilitic) 94.89 A52.19

Miosis (persistent), not due to miotics 379.42 H57.03

Mydriasis (persistent), not due to mydriatics 379.43 H57.04

Other anomalies of pupillary function 379.49 H57.09

Pupillary abnormalities (anatomical/mechanical) 364.75 H21.561 H21.562 H21.563

Diagnosis ICD-9

Code

ICD-10 Code

Right Eye Left Eye Bilateral

Accommodative paresis 367.51 H52.521 H52.522 H52.523

Accommodative spasm 367.53 H52.531 H52.532 H52.533

Total / complete internal ophthalmoplegia 367.52 H52.511 H52.512 H52.513

Diagnosis ICD-9

Code

ICD-10 Code

Right Eye Left Eye Bilateral

Amblyopia, deprivation 368.02 H53.011 H53.012 H53.013

Amblyopia, refractive 368.03 H53.021 H53.022 H53.023

Amblyopia, strabismic 368.01 H53.031 H53.032 H53.033

Diagnosis ICD-9 Code ICD-10 Code

Chiasmal disease, associated with pituitary neoplasm 377.51 H47.42

Chiasmal disease, associated with other neoplasm (glioma, meningioma) 377.52 H47.42

Chiasmal disease, associated with vascular disorders (aneurysm) 377.53 H47.43

Chiasmal disease, associated with inflammatory disorders 377.54 H47.41

Eye Movement Disorders

Eyelid Disorders

Facial Disorders

Diagnosis ICD-9 Code ICD-10 Code

Deficiencies of saccadic eye movements 379.57 H55.81

Deficiencies of smooth pursuit movements 379.58 H55.89

Nystagmus, associated with disorders of vestibular system 379.54 H55.09

Nystagmus, congenital 379.51 H55.01

Nystagmus, dissociated 379.55 H55.04

Nystagmus, latent 379.52 H55.02

Nystagmus, visual deprivation 379.53 H55.03

Nystagmus, other forms (includes superior oblique myokymia) 379.56 H55.09

Other irregular eye movements 379.59 H55.89

Diagnosis ICD-9

Code

ICD-10 Code

RUL RLL LUL LLL

Abnormal innervation syndrome of eyelid 374.43 H02.511 H02.512 H02.514 H02.515

Lagophthalmos, cicatricial 374.23 H02.211 H02.212 H02.214 H02.215

Lagophthalmos, mechanical 374.22 H02.221 H02.222 H02.224 H02.225

Lagophthalmos, paralytic 374.21 H02.231 H02.232 H02.234 H02.235

Lid retraction or lag 374.41 H02.531 H02.532 H02.534 H02.535

Ptosis, mechanical 374.33 H02.411 H02.412 H02.414 H02.415

Ptosis, myogenic 374.32 H02.421 H02.422 H02.424 H02.425

Ptosis, paralytic 374.31 H02.431 H02.432 H02.434 H02.435

Diagnosis ICD-9 Code ICD-10 Code

Bell’s palsy (CN7 palsy) 351.0 G51.0

Blepharospasm 333.81 G24.5

Facial myokymia 351.8 G51.4

Hemifacial spasm 351.8 G51.3

Herpes zoster ophthalmicus B02.39

Melkersson-Rosenthal syndrome 351.8 G51.2

Ramsay-Hunt syndrome 351.8 B02.21

Orbital Disease

Other Visual Pathway Disorders

Diagnosis ICD-9

Code

ICD-10 Code

Right Left Bilateral

Capillary or cavernous hemangioma (orbit) D18.09

Enophthalmos, due to atrophy of orbital tissue H05.411 H05.412 H05.413

Enophthalmos, due to trauma or surgery H05.412 H05.422 H05.423

Thyrotoxic exophthalmos (descriptor) 376.21 H05.89

Exophthalmic ophthalmoplegia (Graves) 376.22 H05.89

Exophthalmos, constant 376.31 H05.241 H05.242 H05.243

Exophthalmos, intermittent 376.34 H05.251 H05.252 H05.253

Exophthalmos, pulsating 376.35 H05.261 H05.262 H05.263

Lateral displacement of globe 376.36 H05.211 H05.212 H05.213

Orbital cellulitis 376.01 H05.011 H05.012 H05.013

Orbital edema or congestion 376.33 H05.221 H05.222 H05.223

Orbital granuloma (orbital inflammatory pseudotumor) 376.11 H05.111 H05.112 H05.113

Orbital hemorrhage 376.32 H05.231 H05.232 H05.233

Orbital mass/neoplasm, benign D31.61 D31.62

Orbital mass/neoplasm, malignant C69.61 C69.62

Orbital myositis 376.12 H05.121 H05.122 H05.123

Orbital tendonitis 376.04 H05.041 H05.042 H05.043

Diagnosis ICD-9

Code

ICD-10 Code

Right Left Bilateral

Other visual disorders, assoc. w/neoplasms 377.61 H47.521 H47.522

Other visual disorders, assoc. w/vascular disease 377.62 H47.531 H47.532

Other visual disorders, assoc. w/inflammatory disease 377.63 H47.511 H47.512

Visual Cortex Disorders

Visual Sensory System

Visual Field Loss

Vertical Deviations

Diagnosis ICD-9

Code

ICD-10 Code

Right Left Bilateral

Visual cortex disorders, associated with neoplasms 377.71 H47.631 H47.632

Visual cortex disorders, associated with vascular disease 377.72 H47.641 H47.642

Visual cortex disorders, assoc. with inflammatory disease 377.73 H47.621 H47.622

Cortical blindness 377.75 H47.611 H47.612

Diagnosis ICD-9 Code ICD-10 Code

Abnormal retinal correspondence 368.34 H53.31

Fusion with defective stereopsis 368.33 H53.32

Simultaneous visual perception without fusion 368.32 H53.33

Suppression of binocular vision 368.31 H53.34

Diagnosis ICD-9

Code

ICD-10 Code

Right Left Bilateral

Generalized VF contraction/constriction 368.45 H53.481 H53.482 H53.483

Heteronymous bilateral VF defect (e.g., bitemporal) 368.47 H53.47

Homonymous bilateral VF defects 368.46 H53.461 H53.462

Other localized VF defect (including ring scotoma) 368.44 H53.451 H53.452 H53.453

Scotoma, blind spot enlargement/cecocentral defect 368.42 H53.421 H53.422 H53.423

Scotoma, central 368.41 H53.411 H53.412 H53.413

Sector or arcuate VF defects 368.43 H53.431 H53.432 H53.433

Diagnosis ICD-9 Code

ICD-10 Code

Right Eye Left Eye

Alternating heterophoria 378.45 H50.55

Cyclophoria 378.44 H50.54

Cyclotropia 378.33 H50.411 H50.412

Hypertropia 378.31 H50.21 H50.22

Hypotropia 378.32 H50.21 H50.22

Vertical heterophoria 378.43 H50.53

Eso-deviations

Exo-deviations

Diagnosis ICD-9 Code

ICD-10 Code

Right Eye Left Eye

Esophoria 378.41 H50.51

Esotropia, alternating 378.05 H50.05

Esotropia, alternating with A pattern 378.06 H50.06

Esotropia, alternating with V pattern 378.07 H50.07

Esotropia, alternating with other noncomitancies 378.08 H50.08

Esotropia, monocular 378.01 H50.011 H50.012

Esotropia, monocular with A pattern 378.02 H50.021 H50.022

Esotropia, monocular with V pattern 378.03 H50.031 H50.032

Esotropia, monocular with other noncomitancies 378.04 H50.041 H50.042

Esotropia, intermittent, monocular 378.21 H50.311 H50.312

Esotropia, intermittent, alternating 378.22 H50.32

Esotropia, accommodative component 378.35 H50.43

Diagnosis ICD-9 Code

ICD-10 Code

Right Eye Left Eye

Exophoria 378.42 H50.52

Exotropia, alternating 378.15 H50.15

Exotropia, alternating with A pattern 378.16 H50.16

Exotropia, alternating with V pattern 378.17 H50.17

Exotropia, alternating with other noncomitancies 378.18 H50.18

Exotropia, monocular 378.11 H50.111 H50.112

Exotropia, monocular with A pattern 378.12 H50.121 H50.122

Exotropia, monocular with V pattern 378.13 H50.131 H50.132

Exotropia, monocular with other noncomitancies 378.14 H50.141 H50.142

Exotropia, intermittent, monocular 378.23 H50.331 H50.332

Exotropia, intermittent, alternating 378.24 H50.34

Special Forms Of Strabismus

Diagnosis ICD-9

Code

ICD-10 Code

Right Left Bilateral

3rd nerve palsy 378.52 H49.01 H49.02 H49.03

4th nerve palsy 378.53 H49.11 H49.12 H49.13

6th nerve palsy 378.54 H49.21 H49.22 H49.23

Brown’s sheath syndrome 378.61 H50.611 H50.612

Conjugate gaze palsy 378.81 H51.0

Conjugate gaze spasm 378.82 H51.0

Convergence excess or spasm 378.83 H51.12

Convergence insufficiency or palsy 378.84 H51.11

Divergence anomalies 378.85 H51.8

Duane’s syndrome 378.71 H50.811 H50.812

Internuclear ophthalmoplegia (INO) 378.86 H51.21 H51.22 H51.23

Kearns-Sayre syndrome H49.811 H49.812 H49.813

Mechanical strabismus 378.60 H50.69

Monofixation syndrome 378.34 H50.42

Myopathy of extraocular muscles 376.82 H05.821 H05.822 H05.823

Ophthalmoplegia, external 378.55 H49.31 H49.32 H49.33

Ophthalmoplegia, total 378.56 H49.31 H49.32 H49.33

Other dissociated deviations of eye mvmts (DVD, DHD) 378.87 H51.8

Progressive external ophthalmoplegia (CPEO) 378.72 H49.41 H49.42 H49.43

Strabismus in other neuromuscular disorders (myasthenia) 378.73 H51.89