The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on corneal implants for keratoconus.


Keratoconus is a disease of the cornea which affects the shape of the eyeball and causes refractive errors, some of which cannot be corrected by spectacles or contact lenses. The insertion of clear plastic implants into the cornea is an interventional procedure aiming to restore eyesight in patients with this condition.

Coding recommendations

C46.4 Insertion of prosthesis into cornea

Excludes: Insertion of therapeutic contact lens (C51.5)

In addition ICD-10 code H18.6 Keratoconus or Q13.4 Other congenital corneal malformations or a combination of Dagger(†) and Asterisk(*) codes Q90.-† Down’s syndrome and H19.8A Other disorders of sclera and cornea in diseases classified elsewhere would be assigned. In the ICD-10 4th Edition † and * codes must appear together, sequencing depends on which is the main condition treated or investigated during the consultant episode, if this is not clear the † code is assigned before the * code.