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ICD-10 Guide
ICD-10 CodesH02.136

H02.136

Billable

Senile ectropion of left eye, unspecified eyelid

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

Code Description

ICD-10 H02.136 is a billable code used to indicate a diagnosis of senile ectropion of left eye, unspecified eyelid.

Key Diagnostic Point:

Senile ectropion of the left eye, unspecified eyelid, is a condition characterized by the outward turning of the eyelid margin, often due to age-related changes in the eyelid's structural integrity. The condition primarily affects the lower eyelid and can lead to exposure of the conjunctiva and cornea, resulting in irritation, dryness, and potential complications such as conjunctivitis or corneal abrasion. Anatomically, the eyelids consist of skin, muscle, and connective tissue, with the orbicularis oculi muscle playing a crucial role in eyelid function. As individuals age, the elasticity of the skin and the tone of the muscle decrease, contributing to ectropion. Disease progression may lead to chronic discomfort and visual disturbances if left untreated. Diagnostic considerations include a thorough ocular examination, patient history, and assessment of symptoms such as tearing or irritation. Treatment options may range from conservative management, such as lubricating eye drops, to surgical intervention for severe cases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate; requires clinical evaluation and differentiation from other eyelid disorders.
  • Treatment complexity: Moderate; may involve both non-surgical and surgical options depending on severity.
  • Documentation requirements: Requires detailed clinical notes and symptom descriptions.
  • Coding specificity: Specific to senile ectropion of the left eye, necessitating precise coding.

Audit Risk Factors

  • Common coding errors: Misidentification of the eyelid involved or failure to specify senility.
  • Documentation gaps: Incomplete patient history or lack of symptom detail.
  • Billing challenges: Potential denials if documentation does not support the medical necessity of treatment.

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

Senile ectropion can significantly affect the quality of life for older adults, leading to discomfort and potential complications such as chronic eye irritation or infection. Understanding the epidemiology of this condition is crucial, as it is prevalent among the aging population. Effective management can reduce healthcare utilization by preventing complications and improving patient outcomes, thereby positively impacting population health.

ICD-9 vs ICD-10

Senile ectropion can significantly affect the quality of life for older adults, leading to discomfort and potential complications such as chronic eye irritation or infection. Understanding the epidemiology of this condition is crucial, as it is prevalent among the aging population. Effective management can reduce healthcare utilization by preventing complications and improving patient outcomes, thereby positively impacting population health.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the medical necessity of any surgical procedures performed. Common denials may arise from insufficient documentation or failure to demonstrate the severity of the condition. Coders should ensure that all relevant clinical details are included in the patient’s medical record, and that the procedure codes align with the diagnosis to avoid billing challenges.

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 H02.136?

H02.136 specifically covers senile ectropion of the left eye, which is characterized by the outward turning of the eyelid margin due to age-related changes. It does not cover ectropion caused by trauma, scarring, or other non-age-related factors.

When should H02.136 be used instead of related codes?

H02.136 should be used when the patient presents with senile ectropion specifically affecting the left eyelid. If the condition affects the right eyelid, H02.135 should be used. For ectropion due to other causes, different codes should be selected.

What documentation supports H02.136?

Documentation should include a comprehensive eye examination report, patient history indicating age-related changes, descriptions of symptoms such as irritation or tearing, and any previous treatments attempted.