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ICD-10 Guide
ICD-10 CodesH02.141

H02.141

Billable

Spastic ectropion of right upper eyelid

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

Code Description

ICD-10 H02.141 is a billable code used to indicate a diagnosis of spastic ectropion of right upper eyelid.

Key Diagnostic Point:

Spastic ectropion of the right upper eyelid is characterized by an outward turning of the eyelid margin due to involuntary muscle contractions, often resulting in exposure of the conjunctiva and cornea. This condition can lead to significant discomfort, tearing, and potential complications such as keratitis or corneal ulceration. The anatomy involved includes the orbicularis oculi muscle, which controls eyelid closure, and the surrounding periocular structures, including the lacrimal glands responsible for tear production. Disease progression may vary; if left untreated, the ectropion can worsen, leading to chronic irritation and damage to the ocular surface. Diagnostic considerations include a thorough clinical examination, assessment of eyelid function, and evaluation of associated conditions such as facial nerve palsy or other neurological disorders that may contribute to spasticity. Treatment options typically involve surgical intervention to correct the eyelid position and restore normal function, alongside addressing any underlying causes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a comprehensive evaluation of eyelid function and associated conditions.
  • Treatment complexity: May involve surgical correction and management of underlying neurological issues.
  • Documentation requirements: Detailed clinical notes and evidence of symptoms are necessary for accurate coding.
  • Coding specificity: Specific to spastic ectropion of the right upper eyelid, necessitating precise documentation.

Audit Risk Factors

  • Common coding errors: Misidentification of eyelid conditions or incorrect laterality.
  • Documentation gaps: Incomplete clinical notes regarding the patient's symptoms and treatment history.
  • Billing challenges: Potential denials due to lack of supporting documentation for 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

Neurology

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

The clinical significance of spastic ectropion extends beyond cosmetic concerns, as it can lead to ocular surface damage and chronic discomfort. In terms of population health, conditions like spastic ectropion may be underreported, affecting quality measures related to eye health. Understanding the epidemiology of eyelid disorders can inform healthcare utilization patterns, guiding resource allocation and preventive strategies in ophthalmology.

ICD-9 vs ICD-10

The clinical significance of spastic ectropion extends beyond cosmetic concerns, as it can lead to ocular surface damage and chronic discomfort. In terms of population health, conditions like spastic ectropion may be underreported, affecting quality measures related to eye health. Understanding the epidemiology of eyelid disorders can inform healthcare utilization patterns, guiding resource allocation and preventive strategies in ophthalmology.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for surgical procedures and ensuring that all documentation supports the diagnosis and treatment provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the procedure. Best practices include maintaining thorough clinical notes, ensuring accurate coding, and following up on claims to address any issues promptly.

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 H02.141?

H02.141 specifically covers spastic ectropion of the right upper eyelid, which may occur due to neurological conditions such as Bell's palsy or other forms of facial nerve dysfunction that lead to muscle spasms.

When should H02.141 be used instead of related codes?

H02.141 should be used when the condition is specifically identified as spastic ectropion of the right upper eyelid, differentiating it from other eyelid disorders such as involutional ectropion or ectropion of the left eyelid.

What documentation supports H02.141?

Documentation should include a detailed clinical examination, patient history, description of symptoms, and any diagnostic tests performed to assess eyelid function and associated neurological conditions.