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ICD-10 Guide
ICD-10 CodesH02.106

H02.106

Billable

Unspecified ectropion of left eye, unspecified eyelid

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

Code Description

ICD-10 H02.106 is a billable code used to indicate a diagnosis of unspecified ectropion of left eye, unspecified eyelid.

Key Diagnostic Point:

Ectropion is a condition characterized by the outward turning of the eyelid, which can lead to exposure of the conjunctiva and cornea, resulting in irritation and potential complications such as dryness and infection. In the case of unspecified ectropion of the left eye, the specific eyelid affected is not identified, which may complicate treatment and management. The eyelid anatomy includes the skin, muscle, and connective tissue, all of which play a role in maintaining eyelid position and function. Ectropion can arise from various causes, including age-related changes, scarring, or neurological conditions. The disease progression may lead to chronic irritation, tearing, and even corneal damage if left untreated. Diagnosis typically involves a thorough clinical examination, including assessment of eyelid position, tear film stability, and overall ocular health. Diagnostic considerations may also include ruling out underlying conditions that could contribute to eyelid malposition. Management may involve conservative measures such as lubricating eye drops or surgical intervention to restore normal eyelid function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires a thorough examination to differentiate from other eyelid disorders.
  • Treatment complexity: Moderate, as treatment may vary from conservative to surgical options.
  • Documentation requirements: Moderate, necessitating detailed clinical notes to support the diagnosis.
  • Coding specificity: Medium, as it is specific to the left eye but does not specify the eyelid.

Audit Risk Factors

  • Common coding errors: Misidentification of the eyelid or eye involved.
  • Documentation gaps: Insufficient clinical details to justify the diagnosis.
  • Billing challenges: Potential denials due to lack of specificity or supporting documentation.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Ectropion can significantly impact a patient's quality of life, leading to discomfort and potential vision problems. Understanding the epidemiology of ectropion, particularly in aging populations, is crucial for healthcare providers. Effective management can reduce healthcare utilization by preventing complications such as corneal ulcers and infections, thereby improving overall patient outcomes and quality measures in ophthalmic care.

ICD-9 vs ICD-10

Ectropion can significantly impact a patient's quality of life, leading to discomfort and potential vision problems. Understanding the epidemiology of ectropion, particularly in aging populations, is crucial for healthcare providers. Effective management can reduce healthcare utilization by preventing complications such as corneal ulcers and infections, thereby improving overall patient outcomes and quality measures in ophthalmic care.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the treatment provided, whether it is conservative management or surgical intervention. Common denials may arise from insufficient documentation or lack of specificity in the diagnosis. Coders should ensure that all relevant clinical notes, including the patient's history and examination findings, are included to support the claim. Best practices include using precise coding and maintaining thorough documentation to minimize audit risks.

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 H02.106?

H02.106 covers unspecified ectropion of the left eye, which may result from various etiologies including age-related changes, trauma, or neurological conditions affecting eyelid function.

When should H02.106 be used instead of related codes?

H02.106 should be used when the ectropion is specifically noted as occurring in the left eye without further specification of the eyelid. If the eyelid is specified, a more specific code should be selected.

What documentation supports H02.106?

Documentation should include a detailed clinical examination, patient history, and any relevant imaging or diagnostic tests that support the diagnosis of ectropion in the left eye.