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ICD-10 Guide
ICD-10 CodesH01.002

H01.002

Billable

Unspecified blepharitis right lower eyelid

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

Code Description

ICD-10 H01.002 is a billable code used to indicate a diagnosis of unspecified blepharitis right lower eyelid.

Key Diagnostic Point:

Unspecified blepharitis of the right lower eyelid is characterized by inflammation of the eyelid margins, which can lead to symptoms such as redness, swelling, and crusting. The condition may be caused by seborrheic dermatitis, staphylococcal infection, or meibomian gland dysfunction. The anatomy involved includes the eyelid itself, which consists of skin, muscle, and connective tissue, as well as the associated structures such as eyelashes and meibomian glands that secrete oils to maintain tear film stability. Disease progression can vary; if left untreated, blepharitis may lead to complications such as conjunctivitis or keratitis. Diagnostic considerations include a thorough patient history, physical examination of the eyelids, and possibly laboratory tests to identify underlying causes. Clinicians should assess for associated symptoms like dry eye or ocular discomfort, which can complicate the clinical picture.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other eyelid disorders such as chalazia or styes.
  • Treatment complexity: Management may involve topical antibiotics, steroids, or hygiene measures.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis and treatment plan.
  • Coding specificity: Limited to unspecified blepharitis, which may require further specification in clinical documentation.

Audit Risk Factors

  • Common coding errors: Misidentifying the eyelid affected or failing to specify the type of blepharitis.
  • Documentation gaps: Incomplete patient history or lack of detail in clinical findings.
  • Billing challenges: Potential for denials if the documentation does not clearly support the diagnosis.

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

Dermatology

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

Unspecified blepharitis, while often benign, can significantly affect patient quality of life due to discomfort and cosmetic concerns. Understanding its prevalence and management is crucial for improving population health outcomes. Effective treatment can reduce healthcare utilization patterns, such as unnecessary visits to specialists or emergency care for complications. Epidemiologically, blepharitis is common, particularly in individuals with skin conditions or ocular surface diseases, highlighting the need for awareness and effective management strategies.

ICD-9 vs ICD-10

Unspecified blepharitis, while often benign, can significantly affect patient quality of life due to discomfort and cosmetic concerns. Understanding its prevalence and management is crucial for improving population health outcomes. Effective treatment can reduce healthcare utilization patterns, such as unnecessary visits to specialists or emergency care for complications. Epidemiologically, blepharitis is common, particularly in individuals with skin conditions or ocular surface diseases, highlighting the need for awareness and effective management strategies.

Reimbursement & Billing Impact

Reimbursement may be affected by the specificity of the diagnosis; therefore, using more specific codes when available is advisable. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the services rendered. Adhering to coding best practices, including regular training on coding updates and guidelines, can mitigate these challenges.

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 H01.002?

H01.002 covers unspecified blepharitis affecting the right lower eyelid, which may include various forms of eyelid inflammation without a specified etiology. It encompasses conditions that cause irritation, crusting, and inflammation of the eyelid margins.

When should H01.002 be used instead of related codes?

H01.002 should be used when the clinician has determined that the blepharitis is present on the right lower eyelid but has not specified the type or cause. If a specific type of blepharitis is diagnosed, a more specific code should be selected.

What documentation supports H01.002?

Documentation should include a detailed clinical examination of the eyelid, patient history regarding symptoms, any previous treatments, and the clinician's assessment of the condition. Photographic evidence may also support the diagnosis.