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ICD-10 Guide
ICD-10 CodesH02.023

H02.023

Billable

Mechanical entropion of right eye, unspecified eyelid

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

Code Description

ICD-10 H02.023 is a billable code used to indicate a diagnosis of mechanical entropion of right eye, unspecified eyelid.

Key Diagnostic Point:

Mechanical entropion of the right eye, unspecified eyelid, is characterized by the inward turning of the eyelid margin, which can lead to irritation of the conjunctiva and cornea due to the eyelashes rubbing against the ocular surface. This condition can arise from various factors, including age-related changes, scarring from previous injuries, or chronic inflammation. The anatomy involved includes the eyelid, which consists of skin, muscle, and connective tissue, as well as the lacrimal system that plays a role in tear production and drainage. Disease progression may lead to discomfort, redness, tearing, and potential vision impairment if left untreated. Diagnostic considerations include a thorough ocular examination, patient history, and possibly imaging studies to assess the extent of the entropion and any associated complications. Treatment options may range from conservative measures, such as lubricating eye drops, to surgical intervention to correct the eyelid position and alleviate symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a comprehensive eye examination and understanding of eyelid anatomy.
  • Treatment complexity: May involve both non-surgical and surgical management options.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis and treatment plan.
  • Coding specificity: Specific to mechanical entropion of the right eye, necessitating precise coding.

Audit Risk Factors

  • Common coding errors: Misidentification of the eye or eyelid involved.
  • Documentation gaps: Incomplete clinical notes that do not clearly outline the diagnosis.
  • Billing challenges: Potential denials if the medical necessity is not well-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

Mechanical entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision problems. Understanding the epidemiology of this condition is essential, as it is more prevalent in older populations. Addressing this issue can improve patient outcomes, reduce healthcare utilization, and enhance overall population health by preventing complications associated with untreated eyelid disorders.

ICD-9 vs ICD-10

Mechanical entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision problems. Understanding the epidemiology of this condition is essential, as it is more prevalent in older populations. Addressing this issue can improve patient outcomes, reduce healthcare utilization, and enhance overall population health by preventing complications associated with untreated eyelid disorders.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, so it is essential to verify coverage policies. Common denials may arise from insufficient documentation or lack of clear indication for surgical intervention. Best practices include maintaining thorough clinical notes, ensuring accurate coding, and following up on claims to address any issues promptly.

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 H02.023?

H02.023 specifically covers mechanical entropion of the right eye, which can result from various causes such as scarring, age-related changes, or trauma. It is essential to differentiate it from other types of entropion, such as spastic or cicatricial entropion.

When should H02.023 be used instead of related codes?

H02.023 should be used when the diagnosis specifically indicates mechanical entropion of the right eye. If the condition affects the left eye or is of a different type, corresponding codes such as H02.021 or H02.022 should be utilized.

What documentation supports H02.023?

Documentation should include a detailed ocular examination, patient history indicating the onset and duration of symptoms, and any previous treatments attempted. Photographic evidence may also support the diagnosis.