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ICD-10 Guide
ICD-10 CodesH02.01

H02.01

Non-billable

Cicatricial entropion of eyelid

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

Code Description

ICD-10 H02.01 is a used to indicate a diagnosis of cicatricial entropion of eyelid.

Key Diagnostic Point:

Cicatricial entropion of the eyelid is a condition characterized by the inward turning of the eyelid margin due to scarring or fibrosis of the eyelid tissue. This condition can lead to irritation of the cornea and conjunctiva, resulting in symptoms such as redness, tearing, and discomfort. The eyelid anatomy involved includes the skin, muscle, and connective tissue, which, when altered by scarring, can cause the eyelid to fold inward. Cicatricial entropion may result from various causes, including trauma, surgery, or inflammatory conditions such as herpes zoster or chronic blepharitis. Disease progression can lead to significant ocular surface damage if left untreated, potentially resulting in corneal ulcers or vision loss. Diagnosis typically involves a thorough ocular examination, including assessment of eyelid position and function, and may require imaging studies to evaluate the extent of scarring. Treatment options include surgical correction to reposition the eyelid, and addressing the underlying cause of the scarring is crucial for preventing recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful evaluation of eyelid anatomy and function.
  • Treatment complexity: Surgical intervention may be necessary, which involves planning and postoperative care.
  • Documentation requirements: Detailed clinical notes are essential to justify the diagnosis and treatment.
  • Coding specificity: Accurate coding requires differentiation from other forms of entropion.

Audit Risk Factors

  • Common coding errors: Misclassification of entropion types.
  • Documentation gaps: Incomplete records regarding the cause of cicatricial changes.
  • Billing challenges: Potential denials if the medical necessity for surgery is not clearly documented.

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

Plastic Surgery

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

Cicatricial entropion can significantly impact patient quality of life due to discomfort and potential vision loss. Understanding its prevalence and management is crucial for improving population health outcomes. Effective treatment can reduce healthcare utilization by preventing complications such as corneal ulcers. Awareness of this condition among healthcare providers can lead to timely interventions, improving overall patient care and satisfaction.

ICD-9 vs ICD-10

Cicatricial entropion can significantly impact patient quality of life due to discomfort and potential vision loss. Understanding its prevalence and management is crucial for improving population health outcomes. Effective treatment can reduce healthcare utilization by preventing complications such as corneal ulcers. Awareness of this condition among healthcare providers can lead to timely interventions, improving overall patient care and satisfaction.

Reimbursement & Billing Impact

Cicatricial entropion can significantly impact patient quality of life due to discomfort and potential vision loss. Understanding its prevalence and management is crucial for improving population health outcomes. Effective treatment can reduce healthcare utilization by preventing complications such as corneal ulcers. Awareness of this condition among healthcare providers can lead to timely interventions, improving overall patient care and satisfaction.

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 H02.01?

H02.01 specifically covers cicatricial entropion, which is caused by scarring of the eyelid. This includes conditions resulting from trauma, surgery, or inflammatory diseases that lead to eyelid malposition.

When should H02.01 be used instead of related codes?

H02.01 should be used when the entropion is specifically due to cicatricial changes. If the entropion is due to other causes, such as age-related changes or muscle weakness, other codes should be selected.

What documentation supports H02.01?

Documentation should include a detailed history of the eyelid condition, clinical findings from the examination, and any imaging studies performed. Notes should clearly indicate the cicatricial nature of the entropion.