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ICD-10 Guide
ICD-10 CodesH01.019

H01.019

Billable

Ulcerative blepharitis unspecified eye, unspecified eyelid

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

Code Description

ICD-10 H01.019 is a billable code used to indicate a diagnosis of ulcerative blepharitis unspecified eye, unspecified eyelid.

Key Diagnostic Point:

Ulcerative blepharitis is a chronic inflammatory condition affecting the eyelids, characterized by the presence of crusted scales, redness, and irritation. It can occur in one or both eyelids and is often associated with seborrheic dermatitis or staphylococcal infection. The eyelid anatomy involved includes the skin, meibomian glands, and hair follicles, which can become inflamed and obstructed, leading to further complications such as conjunctivitis or keratitis. Disease progression may vary, with patients experiencing episodic flare-ups that can lead to chronic discomfort and potential vision impairment if left untreated. Diagnostic considerations include a thorough patient history, physical examination, and possibly microbiological cultures to identify any underlying infections. Treatment typically involves eyelid hygiene, warm compresses, and topical antibiotics or corticosteroids, depending on the severity of the condition. Regular follow-up is essential to monitor the response to treatment and prevent recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other eyelid disorders such as staphylococcal blepharitis and seborrheic dermatitis.
  • Treatment complexity: May involve multiple treatment modalities including hygiene measures, topical medications, and in some cases, systemic therapy.
  • Documentation requirements: Requires detailed clinical notes to support diagnosis and treatment plans.
  • Coding specificity: Specific to ulcerative blepharitis without further specification of the eye or eyelid.

Audit Risk Factors

  • Common coding errors: Misclassification of blepharitis types or failure to document the chronic nature of the condition.
  • Documentation gaps: Incomplete patient history or lack of follow-up notes may lead to denials.
  • Billing challenges: Potential for denials if the medical necessity is not clearly established in the documentation.

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

Ulcerative blepharitis can significantly impact patient quality of life due to discomfort and potential vision impairment. It is prevalent in various populations, particularly among those with underlying skin conditions. Understanding and managing this condition can improve patient outcomes, reduce healthcare utilization, and enhance overall population health. Quality measures may include tracking treatment effectiveness and patient satisfaction, which are essential for improving care delivery.

ICD-9 vs ICD-10

Ulcerative blepharitis can significantly impact patient quality of life due to discomfort and potential vision impairment. It is prevalent in various populations, particularly among those with underlying skin conditions. Understanding and managing this condition can improve patient outcomes, reduce healthcare utilization, and enhance overall population health. Quality measures may include tracking treatment effectiveness and patient satisfaction, which are essential for improving care delivery.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for the treatment is clearly documented. Common denials may arise from insufficient documentation or failure to demonstrate the chronic nature of the condition. Best practices include maintaining comprehensive records of patient interactions, treatment responses, and any referrals to specialists, which can support claims and reduce the likelihood of audits.

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 H01.019?

H01.019 covers unspecified ulcerative blepharitis, which may include cases caused by various factors such as bacterial infections, seborrheic dermatitis, or other inflammatory conditions affecting the eyelids.

When should H01.019 be used instead of related codes?

H01.019 should be used when the specific cause of blepharitis is unknown or not documented. If the condition is linked to a specific etiology, such as staphylococcal infection, then a more specific code should be utilized.

What documentation supports H01.019?

Documentation should include a detailed clinical examination, patient history, treatment plans, and any diagnostic tests performed. Notes should clearly indicate the chronic nature of the condition and any associated symptoms.