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ICD-10 Guide
ICD-10 CodesH02.202

H02.202

Billable

Unspecified lagophthalmos right lower eyelid

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

Code Description

ICD-10 H02.202 is a billable code used to indicate a diagnosis of unspecified lagophthalmos right lower eyelid.

Key Diagnostic Point:

Lagophthalmos is a condition characterized by the inability to completely close the eyelids, which can lead to exposure of the cornea and subsequent complications such as dryness, irritation, and potential corneal damage. In the case of unspecified lagophthalmos of the right lower eyelid, the patient may present with symptoms such as excessive tearing, redness, and sensitivity to light. The anatomy involved includes the eyelids, which consist of skin, muscle, and connective tissue, as well as the lacrimal system responsible for tear production and drainage. The orbicularis oculi muscle plays a crucial role in eyelid closure, and any dysfunction can lead to lagophthalmos. Disease progression can vary; if left untreated, it may result in chronic keratitis or corneal ulceration. Diagnostic considerations include a thorough clinical examination, assessment of eyelid function, and possibly imaging studies to evaluate underlying causes such as facial nerve palsy or scarring. Treatment may involve lubricating eye drops, eyelid weights, or surgical intervention depending on the severity and underlying cause.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of eyelid anatomy and function.
  • Treatment complexity: May involve multiple treatment modalities.
  • Documentation requirements: Detailed clinical notes needed to support diagnosis.
  • Coding specificity: Must differentiate between types of lagophthalmos.

Audit Risk Factors

  • Common coding errors: Misidentification of eyelid involved.
  • Documentation gaps: Insufficient detail on symptoms and treatment.
  • Billing challenges: Potential denials due to lack of clear clinical rationale.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Lagophthalmos can significantly affect a patient's quality of life, leading to discomfort and potential vision loss if not managed appropriately. Understanding the epidemiology of this condition is crucial, as it can arise from various underlying health issues, including neurological disorders. Effective management can reduce healthcare utilization by preventing complications such as corneal ulcers, thereby improving overall population health outcomes.

ICD-9 vs ICD-10

Lagophthalmos can significantly affect a patient's quality of life, leading to discomfort and potential vision loss if not managed appropriately. Understanding the epidemiology of this condition is crucial, as it can arise from various underlying health issues, including neurological disorders. Effective management can reduce healthcare utilization by preventing complications such as corneal ulcers, thereby improving overall population health outcomes.

Reimbursement & Billing Impact

Reimbursement may depend on demonstrating medical necessity, particularly if surgical interventions are involved. Common denials may arise from insufficient documentation or failure to provide a clear rationale for the diagnosis. Coders should ensure that all relevant clinical details are included in the patient’s record to support the coding and billing process. Best practices include regular audits of documentation and coding accuracy to minimize errors and improve claim acceptance rates.

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 H02.202?

H02.202 covers unspecified lagophthalmos of the right lower eyelid, which may arise from various causes including facial nerve dysfunction, trauma, or congenital conditions. It is important to document the underlying cause if known.

When should H02.202 be used instead of related codes?

H02.202 should be used when the lagophthalmos is specifically noted as affecting the right lower eyelid and no further specification is available. If the condition is bilateral or affects other eyelids, different codes should be considered.

What documentation supports H02.202?

Documentation should include a detailed history of the patient's symptoms, clinical examination findings, any imaging studies performed, and treatment plans. Notes should clearly indicate the right lower eyelid's involvement.