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ICD-10 Guide
ICD-10 CodesH02.02

H02.02

Non-billable

Mechanical entropion of eyelid

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

Code Description

ICD-10 H02.02 is a used to indicate a diagnosis of mechanical entropion of eyelid.

Key Diagnostic Point:

Mechanical entropion of the eyelid is a condition characterized by the inward turning of the eyelid margin, which can lead to irritation and damage to the cornea due to direct contact with the eyelashes. This condition often arises from mechanical factors such as scarring, laxity of the eyelid tissue, or the presence of a mass that distorts the eyelid's normal position. The anatomy involved includes the eyelids, which consist of skin, muscle, and connective tissue, as well as the underlying orbicularis oculi muscle that facilitates eyelid movement. Disease progression can lead to chronic irritation, corneal abrasion, and potential vision impairment if left untreated. Diagnostic considerations include a thorough ocular examination, assessment of eyelid position, and evaluation of any underlying conditions contributing to the mechanical entropion. Clinicians may utilize tools such as slit-lamp examination to assess corneal health and eyelid anatomy, ensuring a comprehensive approach to diagnosis and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough ocular examination and understanding of eyelid anatomy.
  • Treatment complexity: May involve surgical intervention or conservative management depending on severity.
  • Documentation requirements: Detailed clinical notes on symptoms, examination findings, and treatment plans are necessary.
  • Coding specificity: Requires accurate coding to differentiate from other types of entropion and eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misclassification of entropion type or failure to document underlying causes.
  • Documentation gaps: Incomplete clinical notes regarding the mechanical factors contributing to the condition.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis and treatment provided.

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

Mechanical entropion can significantly impact patient quality of life due to discomfort and potential vision loss. It is essential for healthcare providers to recognize and treat this condition promptly to prevent complications. Understanding the epidemiology of eyelid disorders, including mechanical entropion, can help inform public health initiatives aimed at improving ocular health and reducing the burden of eye-related diseases in the population.

ICD-9 vs ICD-10

Mechanical entropion can significantly impact patient quality of life due to discomfort and potential vision loss. It is essential for healthcare providers to recognize and treat this condition promptly to prevent complications. Understanding the epidemiology of eyelid disorders, including mechanical entropion, can help inform public health initiatives aimed at improving ocular health and reducing the burden of eye-related diseases in the population.

Reimbursement & Billing Impact

Reimbursement may depend on the severity of the condition and the complexity of the surgical procedure performed. Common denials can occur if the documentation does not sufficiently support the medical necessity of the procedure. Coders should ensure that all relevant clinical information is included in the patient's record, including the rationale for surgical intervention and any preoperative assessments. Best practices include using precise coding and maintaining clear communication with payers regarding the treatment plan.

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 H02.02?

H02.02 specifically covers mechanical entropion, which is caused by external factors such as scarring, eyelid laxity, or tumors affecting eyelid position. It does not cover spastic or involutional entropion.

When should H02.02 be used instead of related codes?

H02.02 should be used when the entropion is specifically due to mechanical causes. If the entropion is due to muscle spasms or age-related changes, other codes such as H02.01 or H02.03 should be considered.

What documentation supports H02.02?

Documentation should include a detailed history of symptoms, results from a comprehensive eye examination, and any imaging studies if applicable. Notes should clearly indicate the mechanical cause of the entropion.