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ICD-10 Guide
ICD-10 CodesH02.34

H02.34

Billable

Blepharochalasis left upper eyelid

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

Code Description

ICD-10 H02.34 is a billable code used to indicate a diagnosis of blepharochalasis left upper eyelid.

Key Diagnostic Point:

Blepharochalasis of the left upper eyelid is characterized by the recurrent swelling and atrophy of the eyelid skin, leading to excess skin and laxity. This condition typically presents as a drooping or sagging eyelid, which may affect vision and contribute to cosmetic concerns. The anatomy involved includes the skin, muscle, and connective tissue of the eyelid, as well as the underlying orbicularis oculi muscle. Disease progression can vary, with some patients experiencing intermittent episodes of swelling that may resolve spontaneously, while others may develop persistent eyelid redundancy. Diagnostic considerations include a thorough clinical examination, patient history, and possibly imaging studies to rule out other orbital or eyelid pathologies. It is essential to differentiate blepharochalasis from other eyelid disorders such as ptosis or dermatochalasis, which may require different management approaches.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misidentifying the laterality of the condition.
  • Documentation gaps may arise if the clinical significance of the eyelid changes is not adequately recorded.
  • Billing challenges can occur if the necessity for surgical intervention is not clearly justified.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Blepharochalasis can significantly impact a patient's quality of life, affecting both vision and self-esteem. Understanding the epidemiology of this condition is crucial, as it may be more prevalent in certain populations. Healthcare utilization patterns may show increased visits to ophthalmology and dermatology specialists for evaluation and management. Quality measures should focus on patient-reported outcomes and satisfaction following treatment.

ICD-9 vs ICD-10

Blepharochalasis can significantly impact a patient's quality of life, affecting both vision and self-esteem. Understanding the epidemiology of this condition is crucial, as it may be more prevalent in certain populations. Healthcare utilization patterns may show increased visits to ophthalmology and dermatology specialists for evaluation and management. Quality measures should focus on patient-reported outcomes and satisfaction following treatment.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for surgical intervention is clearly documented. Common denials may occur if the documentation does not adequately support the diagnosis or if the procedure is deemed cosmetic rather than medically necessary. Coding best practices involve using the most specific code available and ensuring that all relevant clinical information is included in the patient's medical record.

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 H02.34?

H02.34 specifically covers blepharochalasis of the left upper eyelid, which is characterized by recurrent eyelid swelling and subsequent skin laxity. It is important to distinguish this from other eyelid conditions such as ptosis or dermatochalasis.

When should H02.34 be used instead of related codes?

H02.34 should be used when the clinical presentation specifically involves the left upper eyelid with features of blepharochalasis. It is essential to document the laterality and specific symptoms to differentiate from other eyelid disorders.

What documentation supports H02.34?

Documentation should include a detailed clinical examination, patient history of eyelid swelling, and any previous treatments. Photographic evidence may also support the diagnosis, particularly if surgical intervention is being considered.