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ICD-10 Guide
ICD-10 CodesH02.132

H02.132

Billable

Senile ectropion of right lower eyelid

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

Code Description

ICD-10 H02.132 is a billable code used to indicate a diagnosis of senile ectropion of right lower eyelid.

Key Diagnostic Point:

Senile ectropion of the right lower eyelid is a condition characterized by the outward turning of the eyelid margin, primarily affecting older adults due to age-related changes in the skin and connective tissue. Clinically, patients may present with symptoms such as irritation, excessive tearing, and exposure of the conjunctiva, leading to potential complications like conjunctivitis or corneal exposure. The anatomy involved includes the lower eyelid, orbicularis oculi muscle, and the surrounding periocular structures. Disease progression typically involves gradual weakening of the eyelid's support structures, resulting in laxity and the ectropion formation. Diagnostic considerations include a thorough ocular examination, patient history, and assessment of associated symptoms. In some cases, imaging may be warranted to evaluate underlying structural issues. Treatment often involves surgical intervention to restore eyelid position and function, emphasizing the importance of accurate diagnosis and coding for effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires a clinical examination and understanding of eyelid anatomy.
  • Treatment complexity: Medium, involving potential surgical procedures.
  • Documentation requirements: Moderate, necessitating detailed clinical notes and symptom descriptions.
  • Coding specificity: High, as it specifically identifies the condition and location.

Audit Risk Factors

  • Common coding errors: Misidentifying the side of ectropion or using a general code.
  • Documentation gaps: Incomplete symptom descriptions or lack of clinical rationale for the diagnosis.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect coding.

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

Senile ectropion significantly impacts the quality of life for affected individuals, leading to discomfort and potential complications such as chronic conjunctivitis. Understanding the epidemiology of this condition is crucial, as it predominantly affects the aging population, highlighting the need for effective management strategies. Quality measures should focus on timely diagnosis and appropriate surgical intervention to improve patient outcomes and reduce healthcare utilization.

ICD-9 vs ICD-10

Senile ectropion significantly impacts the quality of life for affected individuals, leading to discomfort and potential complications such as chronic conjunctivitis. Understanding the epidemiology of this condition is crucial, as it predominantly affects the aging population, highlighting the need for effective management strategies. Quality measures should focus on timely diagnosis and appropriate surgical intervention to improve patient outcomes and reduce healthcare utilization.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for surgical procedures, especially if performed in an outpatient setting. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include ensuring that all clinical notes are thorough and that the coding accurately reflects the condition and treatment provided.

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 H02.132?

H02.132 specifically covers senile ectropion of the right lower eyelid, a condition where the eyelid turns outward due to age-related changes. It may also encompass associated symptoms like irritation and tearing.

When should H02.132 be used instead of related codes?

H02.132 should be used when the diagnosis specifically involves senile ectropion of the right lower eyelid, differentiating it from left-sided or other types of ectropion.

What documentation supports H02.132?

Documentation should include a detailed clinical examination, patient history, symptom description, and any relevant imaging studies that support the diagnosis of ectropion.