The ICD-10 code range H00-H05 covers disorders of the eyelid, lacrimal system, and orbit. These codes are utilized to document conditions such as blepharitis, chalazion, xanthelasma of eyelid, dacryocystitis, and disorders of the orbit. The range is comprehensive, covering both congenital and acquired conditions, and includes both specific and unspecified codes for various disorders.

Key Usage Points:

•Always code to the highest level of specificity.
•Use additional codes for associated symptoms if not included in the code description.
•For bilateral conditions, if there is no bilateral code, assign separate codes for both the left and right side.
•When coding for aftercare, use the appropriate Z code.
•For conditions classifiable to H00-H05 but complicating pregnancy, childbirth, or the puerperium, code first the obstetric complication.

Coding Guidelines

When to Use:

✓When a patient presents with a disorder of the eyelid, lacrimal system, or orbit.
✓When a patient is being treated for aftercare following surgery for a disorder in this range.
✓When a patient has a congenital disorder of the eyelid, lacrimal system, or orbit.
✓When a patient has a systemic disease with related eyelid, lacrimal system, or orbit manifestations.

When NOT to Use:

✗When a patient has a temporary injury, such as a contusion or abrasion of the eye or eyelid.
✗When a patient has a disorder of the eye itself, such as conjunctivitis or glaucoma.
✗When a patient has a disorder of the visual system, such as strabismus or amblyopia.
✗When a patient has a disorder of the adnexa, such as a stye or hordeolum.

Code Exclusions

Always verify exclusions with the most current version of the ICD-10.

Documentation Requirements

Documentation for disorders of the eyelid, lacrimal system, and orbit should include the specific diagnosis, laterality, and any related symptoms or conditions. If the condition is due to an underlying disease, this should also be documented.

Clinical Information:

•Specific diagnosis
•Laterality
•Underlying disease, if applicable
•Related symptoms or conditions
•Outcome of any surgical intervention

Supporting Evidence:

•Clinical notes
•Imaging reports
•Laboratory results
•Operative reports

Good Documentation Example:

Patient presents with chronic inflammation of both eyelids. Diagnosis: Bilateral blepharitis.

Poor Documentation Example:

Patient has eye inflammation.

Common Documentation Errors:

⚠Not specifying laterality
⚠Not documenting underlying disease
⚠Not documenting related symptoms or conditions
⚠Not documenting outcome of surgical intervention

Range Statistics

Total Codes

169

Billable

Complexity:

Medium

Primary Use:Clinical Documentation

Chapter:

Coding Complexity

Medium

Complexity Rating

The complexity of coding for disorders of the eyelid, lacrimal system, and orbit is considered medium due to the need to accurately determine laterality, identify any underlying disease, and code for related symptoms or conditions. Additionally, coding for aftercare following surgery can add to the complexity.

Key Factors:

▸Determining laterality
▸Identifying underlying disease
▸Coding for related symptoms or conditions
▸Coding for aftercare following surgery

Specialty Focus

These codes are most commonly used in ophthalmology, but may also be used in primary care, emergency medicine, and other specialties when relevant.

Primary Specialties:

Ophthalmology

80%

Primary Care

15%

Clinical Scenarios:

• Patient presents with a lump on the upper eyelid. Diagnosis: Chalazion of right upper eyelid.
• Patient presents with tearing and discharge from the left eye. Diagnosis: Acute dacryocystitis of left lacrimal sac.
• Patient presents with double vision and bulging eyes. Diagnosis: Graves' disease with orbitopathy.
• Patient presents for follow-up after surgery for orbital fracture. Diagnosis: Aftercare following surgery for fracture of orbit.

Resources & References

Resources for coding disorders of the eyelid, lacrimal system, and orbit include the official ICD-10 guidelines, clinical reference sources, and educational materials.

Official Guidelines:

ICD-10-CM Official Guidelines for Coding and Reporting
American Academy of Ophthalmology ICD-10 Coding Resources
World Health Organization ICD-10 Browser

Clinical References:

American Academy of Ophthalmology Clinical Education
Medscape Ophthalmology Clinical Reference

Educational Materials:

American Academy of Professional Coders ICD-10 Training
American Health Information Management Association ICD-10 Resources

Frequently Asked Questions

How do I code for a disorder of the eyelid, lacrimal system, or orbit that is due to an underlying disease?

First code the underlying disease, followed by the appropriate code from the H00-H05 range for the disorder of the eyelid, lacrimal system, or orbit.