episcleritis

DEFINITION of episcleritis

Episcleritis is a benign, usually idiopathic inflammatory condition affecting the episcleral tissue, which is the superficial layer overlying the white of the eye (sclera). It manifests as sectoral or diffuse injection (redness) of the eye, often accompanied by mild tenderness, irritation, and lacrimation, but notably without significant visual disturbance or pain severe enough to suggest scleritis. It occurs in two primary clinical forms: simple (diffuse) and nodular. A third variant, episcleritis periodica fugax, is a transient, recurrent form that resolves spontaneously within hours to days. While most cases are idiopathic, episcleritis can be associated with systemic conditions such as rheumatoid arthritis, inflammatory bowel disease, gout, rosacea, or — less commonly — tuberculosis. It is differentiated from the more serious scleritis by the blanching of episcleral vessels with topical phenylephrine (the “phenylephrine blanching test”), the absence of deep boring pain, and its generally benign, self-resolving course. Related / Differential Terms: scleritis, conjunctivitis, uveitis, keratitis, pinguecula, pterygium

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ETYMOLOGY of episcleritis

greek

|Component|Origin|Meaning| |---|---|---| |Epi-|Greek ἐπί (epí)|Upon / over| |Sclera|Greek σκληρός (sklērós)|Hard| |-itis|Greek -ῖτις (-îtis)|Inflammation|

Literally: “inflammation upon the hard [coat of the eye]”

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CODING AND NUANCES

🏥 ICD-10-CM Codes

Primary Episcleritis (H15.1xx)

Code	Description
H15.101	Unspecified episcleritis, right eye
H15.102	Unspecified episcleritis, left eye
H15.103	Unspecified episcleritis, bilateral
H15.109	Unspecified episcleritis, unspecified eye
H15.111	Episcleritis periodica fugax, right eye
H15.112	Episcleritis periodica fugax, left eye
H15.113	Episcleritis periodica fugax, bilateral
H15.119	Episcleritis periodica fugax, unspecified eye
H15.121	Nodular episcleritis, right eye
H15.122	Nodular episcleritis, left eye
H15.123	Nodular episcleritis, bilateral
H15.129	Nodular episcleritis, unspecified eye

Infectious Etiology

Code	Description
A18.51	Tuberculous episcleritis

⚠️ Coding notes All H15.1xx codes are 7 characters and valid for HIPAA transactions. Laterality must be specified when documented. If associated with a systemic disease (e.g., rheumatoid arthritis, IBD), code the underlying condition additionally per etiology/manifestation convention.

🔧 CPT Codes

Episcleritis is treated medically (topical NSAIDs, corticosteroids, lubricants), so there are no procedure-specific CPT codes for episcleritis itself. Relevant CPT codes are for the associated E&M and diagnostic services:

CPT Code	Description
92002	Ophthalmological services, new patient, intermediate
92004	Ophthalmological services, new patient, comprehensive
92012	Ophthalmological services, established patient, intermediate
92014	Ophthalmological services, established patient, comprehensive
92250	Fundus photography (if performed to r/o posterior involvement)
92285	External ocular photography (anterior segment)

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DERIVATIONS of episcleritis

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Query functionality

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Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms