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ICD-10 Guide
ICD-10 CodesH02.051

H02.051

Billable

Trichiasis without entropion right upper eyelid

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

Code Description

ICD-10 H02.051 is a billable code used to indicate a diagnosis of trichiasis without entropion right upper eyelid.

Key Diagnostic Point:

Trichiasis is a condition characterized by the misdirection of eyelashes, causing them to rub against the cornea and conjunctiva, leading to irritation, discomfort, and potential damage to the ocular surface. In the case of H02.051, the condition specifically affects the right upper eyelid. The eyelid anatomy includes the skin, muscles, and connective tissue that support eyelid function, as well as the eyelashes themselves. The lacrimal system, which includes the tear glands and drainage system, may also be affected due to the irritation caused by misdirected lashes. Disease progression can lead to chronic irritation, corneal abrasions, and even vision impairment if left untreated. Diagnosis typically involves a thorough ocular examination, including assessment of eyelid position and eyelash orientation. Treatment options may include epilation (removal of the misdirected eyelashes), cryotherapy, or surgical intervention to correct the eyelid position. Proper documentation of the clinical presentation, including symptoms and examination findings, is crucial for accurate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful examination to differentiate from other eyelid disorders.
  • Treatment complexity: May involve multiple treatment modalities depending on severity.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis.
  • Coding specificity: Requires precise coding to reflect the specific eyelid affected.

Audit Risk Factors

  • Common coding errors: Misidentifying the eyelid affected or confusing with entropion.
  • Documentation gaps: Incomplete clinical notes may lead to coding inaccuracies.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis.

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

Trichiasis can significantly impact a patient's quality of life due to discomfort and potential vision impairment. It is essential for healthcare providers to recognize and treat this condition to prevent complications. The prevalence of trichiasis varies, with higher rates observed in certain populations, particularly those with a history of trauma or chronic inflammatory conditions. Addressing trichiasis can improve patient outcomes and reduce healthcare utilization related to complications from untreated eyelid disorders.

ICD-9 vs ICD-10

Trichiasis can significantly impact a patient's quality of life due to discomfort and potential vision impairment. It is essential for healthcare providers to recognize and treat this condition to prevent complications. The prevalence of trichiasis varies, with higher rates observed in certain populations, particularly those with a history of trauma or chronic inflammatory conditions. Addressing trichiasis can improve patient outcomes and reduce healthcare utilization related to complications from untreated eyelid disorders.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for surgical interventions and ensuring that the diagnosis is clearly linked to the services billed. Common denials may arise from insufficient documentation or coding errors, particularly if the specific eyelid affected is not clearly noted. Best practices include thorough clinical notes, clear coding, and following payer-specific guidelines for billing.

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 H02.051?

H02.051 specifically covers trichiasis affecting the right upper eyelid without the presence of entropion. It is important to differentiate this condition from other eyelid disorders such as entropion, ectropion, and blepharitis.

When should H02.051 be used instead of related codes?

H02.051 should be used when the patient presents with misdirected eyelashes on the right upper eyelid without any associated entropion. If entropion is present, a different code should be selected.

What documentation supports H02.051?

Documentation should include a detailed description of the patient's symptoms, findings from the ocular examination, and any treatments attempted. Photographic evidence may also be beneficial in supporting the diagnosis.