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ICD-10 Guide
ICD-10 CodesH02.142

H02.142

Billable

Spastic ectropion of right lower eyelid

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

Code Description

ICD-10 H02.142 is a billable code used to indicate a diagnosis of spastic ectropion of right lower eyelid.

Key Diagnostic Point:

Spastic ectropion of the right lower eyelid is characterized by an outward turning of the eyelid margin due to involuntary muscle contractions, often resulting from neurological conditions such as blepharospasm or facial nerve dysfunction. The lower eyelid's anatomy includes the skin, orbicularis oculi muscle, tarsal plate, and conjunctiva, all of which can be affected by this condition. Clinically, patients may present with symptoms such as excessive tearing, irritation, exposure keratitis, and cosmetic concerns. The disease progression can lead to chronic irritation and potential complications, including corneal damage if left untreated. Diagnostic considerations involve a thorough ocular examination, assessment of eyelid function, and evaluation of underlying neurological conditions. Imaging studies may be warranted to rule out structural abnormalities or other orbital conditions contributing to the ectropion.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of eyelid anatomy and associated neurological conditions.
  • Treatment complexity: May involve surgical intervention or management of underlying neurological issues.
  • Documentation requirements: Detailed clinical notes and history of symptoms are essential.
  • Coding specificity: Requires precise coding to differentiate from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misidentification of the eyelid affected or confusion with other ectropion types.
  • Documentation gaps: Incomplete patient history or lack of detailed examination notes.
  • Billing challenges: Potential denials if the medical necessity is not clearly established.

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

Spastic ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision impairment. Understanding its prevalence and impact on population health is crucial for developing effective treatment strategies. Quality measures may include tracking patient outcomes post-treatment and ensuring timely referrals to specialists. Epidemiologically, conditions leading to spastic ectropion, such as neurological disorders, highlight the need for integrated care approaches in managing complex cases.

ICD-9 vs ICD-10

Spastic ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision impairment. Understanding its prevalence and impact on population health is crucial for developing effective treatment strategies. Quality measures may include tracking patient outcomes post-treatment and ensuring timely referrals to specialists. Epidemiologically, conditions leading to spastic ectropion, such as neurological disorders, highlight the need for integrated care approaches in managing complex cases.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the procedure codes align with the diagnosis and that all relevant clinical notes are included. Common denials may arise from insufficient documentation or failure to demonstrate the impact of the condition on the patient's quality of life. Best practices include maintaining clear, concise records 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 H02.142?

H02.142 specifically covers spastic ectropion of the right lower eyelid, which may arise from conditions such as blepharospasm, facial nerve palsy, or other neurological disorders that affect eyelid muscle control.

When should H02.142 be used instead of related codes?

H02.142 should be used when the clinical presentation specifically involves spastic ectropion of the right lower eyelid, differentiating it from other forms of ectropion or eyelid disorders that do not involve spasticity.

What documentation supports H02.142?

Documentation should include a comprehensive ocular examination, patient history detailing the onset and nature of symptoms, and any relevant neurological evaluations that support the diagnosis of spastic ectropion.