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ICD-10 Guide
ICD-10 CodesH02.153

H02.153

Billable

Paralytic ectropion of right eye, unspecified eyelid

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 H02.153 is a billable code used to indicate a diagnosis of paralytic ectropion of right eye, unspecified eyelid.

Key Diagnostic Point:

Paralytic ectropion of the right eye, unspecified eyelid, is characterized by the outward turning of the eyelid margin due to paralysis of the eyelid muscles, often resulting from conditions such as facial nerve palsy. The eyelid anatomy includes the tarsal plate, orbicularis oculi muscle, and various connective tissues that maintain eyelid position and function. In cases of ectropion, the eyelid fails to close properly, leading to exposure of the conjunctiva and cornea, which can result in dryness, irritation, and potential corneal damage. Disease progression may vary; if untreated, patients may experience chronic discomfort, increased risk of infection, and visual impairment. Diagnosis typically involves a comprehensive eye examination, including assessment of eyelid position, function, and associated symptoms. Additional tests may be warranted to evaluate the underlying cause of the paralysis, such as imaging studies or neurological evaluations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of eyelid anatomy and associated neurological conditions.
  • Treatment complexity: May involve surgical intervention or management of underlying conditions.
  • Documentation requirements: Detailed clinical notes on symptoms, examination findings, and treatment plans are necessary.
  • Coding specificity: Requires precise coding to differentiate from other types of ectropion and eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected eyelid or failure to document the underlying cause.
  • Documentation gaps: Incomplete clinical notes regarding the patient's history and examination findings.
  • Billing challenges: Potential for denials if documentation does not clearly support the diagnosis and treatment provided.

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Neurology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of H02.153 lies in its potential to affect patient quality of life due to discomfort and visual impairment. Population health impact includes the need for awareness of neurological conditions that can lead to eyelid paralysis. Quality measures may focus on timely diagnosis and treatment to prevent complications. Healthcare utilization patterns may reflect increased visits to specialists for management of ectropion and its underlying causes, highlighting the importance of interdisciplinary care in these cases.

ICD-9 vs ICD-10

The clinical significance of H02.153 lies in its potential to affect patient quality of life due to discomfort and visual impairment. Population health impact includes the need for awareness of neurological conditions that can lead to eyelid paralysis. Quality measures may focus on timely diagnosis and treatment to prevent complications. Healthcare utilization patterns may reflect increased visits to specialists for management of ectropion and its underlying causes, highlighting the importance of interdisciplinary care in these cases.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear evidence of the condition's impact on the patient's quality of life and any interventions performed. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for surgical procedures. Best practices include maintaining thorough clinical notes, ensuring that all relevant tests and evaluations are documented, and using appropriate modifiers when applicable to support claims.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by H02.153?

H02.153 covers paralytic ectropion specifically affecting the right eyelid, which may result from conditions like Bell's palsy, stroke, or other neurological disorders that impair eyelid function.

When should H02.153 be used instead of related codes?

H02.153 should be used when the ectropion is specifically due to paralysis of the right eyelid. If the left eyelid is affected or if the ectropion is due to other causes, different codes such as H02.151 or H02.159 should be considered.

What documentation supports H02.153?

Documentation should include a detailed history of the patient's symptoms, results from a comprehensive eye examination, and any relevant neurological assessments that indicate the cause of the paralysis.