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ICD-10 Guide
ICD-10 CodesH01.116

H01.116

Billable

Allergic dermatitis of left eye, unspecified eyelid

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

Code Description

ICD-10 H01.116 is a billable code used to indicate a diagnosis of allergic dermatitis of left eye, unspecified eyelid.

Key Diagnostic Point:

Allergic dermatitis of the left eye, unspecified eyelid, is characterized by an inflammatory response of the skin on the eyelid due to exposure to allergens. Clinically, patients may present with symptoms such as redness, swelling, itching, and possibly crusting or scaling of the eyelid skin. The periocular anatomy includes the eyelids, which serve as protective barriers for the eye, and their inflammation can lead to discomfort and visual disturbances. The lacrimal system, responsible for tear production and drainage, may also be affected, leading to excessive tearing or dryness. Disease progression can vary; acute allergic reactions may resolve quickly with avoidance of the allergen, while chronic dermatitis may require ongoing management. Diagnostic considerations include a thorough patient history to identify potential allergens, physical examination, and possibly patch testing to confirm specific sensitivities. Understanding the anatomy involved is crucial for effective treatment and management of symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

Allergic dermatitis of the eyelid can significantly impact a patient's quality of life, leading to discomfort and potential complications such as secondary infections. Understanding the epidemiology of allergic reactions in the population can help healthcare providers implement preventive measures. Quality measures may include tracking the incidence of allergic dermatitis and ensuring appropriate management strategies are in place to reduce healthcare utilization related to this condition.

ICD-9 vs ICD-10

Allergic dermatitis of the eyelid can significantly impact a patient's quality of life, leading to discomfort and potential complications such as secondary infections. Understanding the epidemiology of allergic reactions in the population can help healthcare providers implement preventive measures. Quality measures may include tracking the incidence of allergic dermatitis and ensuring appropriate management strategies are in place to reduce healthcare utilization related to this condition.

Reimbursement & Billing Impact

Reimbursement considerations may vary by payer, so it is important to verify coverage policies. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include thorough documentation of the patient's history, symptoms, and any treatments provided, as well as ensuring that the code accurately reflects the condition being treated.

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 H01.116?

H01.116 covers allergic dermatitis specifically affecting the left eyelid, which can result from various allergens including cosmetics, medications, or environmental factors. It is important to differentiate this from other forms of dermatitis or infections.

When should H01.116 be used instead of related codes?

H01.116 should be used when the allergic dermatitis specifically affects the left eyelid. If the condition affects the right eyelid or both eyelids, other codes such as H01.115 or H01.117 should be considered.

What documentation supports H01.116?

Documentation should include a detailed patient history, description of symptoms, any identified allergens, and results from diagnostic tests such as patch testing. Clinical notes should clearly indicate the affected eyelid.