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ICD-10 Guide
ICD-10 CodesH02.145

H02.145

Billable

Spastic ectropion of left lower eyelid

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

Code Description

ICD-10 H02.145 is a billable code used to indicate a diagnosis of spastic ectropion of left lower eyelid.

Key Diagnostic Point:

Spastic ectropion of the left lower eyelid is characterized by an involuntary spasm of the eyelid muscles, leading to the outward turning of the eyelid margin. This condition can result in exposure of the conjunctiva and cornea, potentially leading to irritation, dryness, and increased risk of infection. The anatomy involved includes the orbicularis oculi muscle, which is responsible for eyelid closure, and the surrounding periocular structures, including the lacrimal system that plays a role in tear drainage and lubrication. Disease progression may vary; if left untreated, spastic ectropion can lead to chronic irritation and complications such as keratitis or corneal ulcers. Diagnosis typically involves a thorough clinical examination, including assessment of eyelid position and function, and may require imaging studies if associated orbital or lacrimal system abnormalities are suspected. Treatment options may include botulinum toxin injections to alleviate muscle spasm, surgical intervention for severe cases, and supportive measures to protect the ocular surface.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly imaging.
  • Treatment complexity: May involve both medical and surgical management.
  • Documentation requirements: Detailed documentation of symptoms and treatment response is necessary.
  • Coding specificity: Requires precise coding to differentiate from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misidentification of eyelid disorders.
  • Documentation gaps: Insufficient detail on clinical findings and treatment.
  • Billing challenges: Potential for denials if documentation does not support 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

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

Spastic ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision complications. Understanding the epidemiology of eyelid disorders is crucial for healthcare providers, as these conditions can impact a large segment of the population, particularly the elderly. Effective management of ectropion can reduce healthcare utilization by preventing complications and improving patient outcomes.

ICD-9 vs ICD-10

Spastic ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision complications. Understanding the epidemiology of eyelid disorders is crucial for healthcare providers, as these conditions can impact a large segment of the population, particularly the elderly. Effective management of ectropion can reduce healthcare utilization by preventing complications and improving patient outcomes.

Reimbursement & Billing Impact

Reimbursement may depend on the documentation of the clinical necessity for treatment, including any surgical interventions. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical information is included in the patient’s record to support the diagnosis and treatment provided, and they should be aware of payer-specific guidelines for billing related to eyelid disorders.

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 H02.145?

H02.145 specifically covers spastic ectropion of the left lower eyelid, which may occur due to neurological conditions, trauma, or idiopathic causes. It is important to differentiate it from other forms of ectropion, such as involutional or cicatricial ectropion.

When should H02.145 be used instead of related codes?

H02.145 should be used when the condition is specifically spastic ectropion of the left lower eyelid. It is essential to use this code when the clinical presentation includes involuntary muscle spasms causing eyelid malposition, as opposed to other types of ectropion.

What documentation supports H02.145?

Documentation should include a detailed history of symptoms, clinical examination findings, and any imaging studies performed. Notes should clearly indicate the diagnosis of spastic ectropion and any treatments attempted, including response to therapy.