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ICD-10 Guide
ICD-10 CodesH02.015

H02.015

Billable

Cicatricial entropion of left lower eyelid

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

Code Description

ICD-10 H02.015 is a billable code used to indicate a diagnosis of cicatricial entropion of left lower eyelid.

Key Diagnostic Point:

Cicatricial entropion of the left lower eyelid is a condition characterized by the inward turning of the eyelid margin due to scarring. This scarring can result from various causes, including trauma, surgery, or inflammatory conditions affecting the eyelid. The left lower eyelid's anatomy includes the skin, muscle, and conjunctiva, which are all involved in the entropion's development. Clinically, patients may present with symptoms such as irritation, tearing, and discomfort due to the eyelashes rubbing against the cornea, leading to potential complications like corneal abrasion or ulceration. Disease progression can vary; if left untreated, it may lead to chronic discomfort and vision impairment. Diagnostic considerations include a thorough ocular examination, patient history, and possibly imaging studies to assess underlying causes. Treatment often involves surgical intervention to correct the eyelid position and address the underlying scarring, making early diagnosis and intervention crucial to prevent complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a detailed ocular examination and understanding of eyelid anatomy.
  • Treatment complexity: Surgical options may vary based on the severity and cause of the entropion.
  • Documentation requirements: Requires thorough documentation of symptoms, examination findings, and treatment plans.
  • Coding specificity: Specific to cicatricial entropion, necessitating precise coding to differentiate from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misclassification with other types of entropion or eyelid disorders.
  • Documentation gaps: Incomplete records of patient history or treatment rationale.
  • 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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cicatricial entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision loss if not addressed. The condition is more prevalent in populations with a history of eyelid trauma or surgery. Understanding its epidemiology can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to timely intervention can improve patient outcomes and reduce healthcare utilization associated with complications.

ICD-9 vs ICD-10

Cicatricial entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision loss if not addressed. The condition is more prevalent in populations with a history of eyelid trauma or surgery. Understanding its epidemiology can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to timely intervention can improve patient outcomes and reduce healthcare utilization associated with complications.

Reimbursement & Billing Impact

impact of the condition on the patient's daily life. Common denials may arise if the surgical procedure is not clearly justified in the documentation. It is advisable to use modifiers where applicable to indicate the specific nature of the procedure performed, especially if multiple procedures are billed during the same encounter.

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 H02.015?

H02.015 specifically covers cicatricial entropion of the left lower eyelid, which is caused by scarring that leads to the inward turning of the eyelid. This can result from various conditions such as trauma, previous surgeries, or chronic inflammation.

When should H02.015 be used instead of related codes?

H02.015 should be used when the entropion is specifically due to cicatricial changes in the left lower eyelid. It is important to differentiate it from other types of entropion, such as involutional or spastic, which have different underlying causes and treatment approaches.

What documentation supports H02.015?

Documentation should include a detailed patient history, clinical examination findings, and any imaging studies performed. It is essential to document the specific cause of cicatricial changes and the impact on the patient's quality of life to support the use of this code.