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ICD-10 Guide
ICD-10 CodesH02.059

H02.059

Billable

Trichiasis without entropion unspecified eye, unspecified eyelid

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

Code Description

ICD-10 H02.059 is a billable code used to indicate a diagnosis of trichiasis without entropion unspecified eye, unspecified 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 H02.059, the diagnosis specifies trichiasis without entropion, indicating that the eyelids are not inverted. The condition can affect either eye and may involve one or more eyelids. The anatomy involved includes the eyelids, eyelashes, cornea, and conjunctiva. The progression of trichiasis can lead to chronic irritation, corneal abrasions, and even vision impairment if left untreated. Diagnostic considerations include a thorough ocular examination, patient history, and assessment of symptoms such as redness, tearing, and foreign body sensation. Treatment options may range from conservative management, such as lubricating eye drops, to surgical interventions like eyelash epilation or eyelid reconstruction, depending on the severity and underlying causes of the condition.

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 both medical and surgical management.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis.
  • Coding specificity: Requires accurate coding to reflect the specific condition and its characteristics.

Audit Risk Factors

  • Common coding errors: Misidentifying trichiasis as entropion or other eyelid disorders.
  • Documentation gaps: Incomplete patient history or lack of detailed examination notes.
  • Billing challenges: Potential denials due to insufficient evidence of medical necessity for procedures.

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 affect patient quality of life, leading to discomfort and potential vision loss if untreated. It is important for healthcare providers to recognize and manage this condition effectively to prevent complications. The prevalence of trichiasis varies, but it is more common in populations with a history of trauma or certain dermatological conditions. Addressing trichiasis contributes to improved ocular health and can reduce healthcare utilization by preventing more severe complications.

ICD-9 vs ICD-10

Trichiasis can significantly affect patient quality of life, leading to discomfort and potential vision loss if untreated. It is important for healthcare providers to recognize and manage this condition effectively to prevent complications. The prevalence of trichiasis varies, but it is more common in populations with a history of trauma or certain dermatological conditions. Addressing trichiasis contributes to improved ocular health and can reduce healthcare utilization by preventing more severe complications.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of procedures performed to address the trichiasis. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for surgical interventions. Coders should ensure that all relevant clinical information is included in the patient's record to support claims and reduce audit risks. Best practices include using precise coding and maintaining thorough documentation of patient interactions and treatment plans.

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 H02.059?

H02.059 covers trichiasis without entropion affecting an unspecified eye and eyelid. It includes cases where eyelashes grow inward but do not cause the eyelid to fold inward, differentiating it from entropion-related conditions.

When should H02.059 be used instead of related codes?

H02.059 should be used when the patient presents with trichiasis without any signs of entropion. If entropion is present, H02.051 should be selected instead. Accurate assessment of eyelid position is crucial for correct coding.

What documentation supports H02.059?

Documentation should include a comprehensive ocular examination, patient symptoms, and any previous treatments attempted. Notes should clearly indicate the absence of entropion and detail the impact of trichiasis on the patient's quality of life.