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v1.0.0
ICD-10 Guide
ICD-10 CodesQ10.1

Q10.1

Billable

Congenital ectropion

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q10.1 is a billable code used to indicate a diagnosis of congenital ectropion.

Key Diagnostic Point:

Congenital ectropion is a condition characterized by the outward turning of the eyelid margin, which can lead to exposure of the conjunctiva and cornea. This malformation can result from various developmental anomalies during gestation, including abnormal muscle development or structural defects in the eyelid. In pediatric patients, congenital ectropion may be associated with other congenital conditions, such as Down syndrome or other chromosomal abnormalities. The condition can lead to significant ocular complications, including dryness, irritation, and potential vision impairment if not addressed. Treatment often involves surgical intervention to correct the eyelid position and protect the ocular surface. Accurate diagnosis and coding are essential for appropriate management and follow-up care, especially in pediatric populations where early intervention can significantly improve outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of ectropion
  • Potential association with other congenital anomalies
  • Need for multidisciplinary documentation (ophthalmology, genetics)
  • Differentiation from acquired ectropion

Audit Risk Factors

  • Inconsistent documentation of associated congenital conditions
  • Failure to specify the type of ectropion (e.g., unilateral vs. bilateral)
  • Inadequate justification for surgical procedures
  • Misclassification of congenital vs. acquired conditions

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed pediatric history, including prenatal factors and family history of congenital conditions.

Common Clinical Scenarios

Infants presenting with eyelid malformations during routine examinations or referrals from pediatricians for suspected congenital conditions.

Billing Considerations

Consideration of developmental milestones and potential impact on vision and overall development.

Genetics

Documentation Requirements

Genetic testing results, family history of chromosomal abnormalities, and any syndromic associations.

Common Clinical Scenarios

Cases where ectropion is part of a syndrome, requiring genetic counseling and testing.

Billing Considerations

Understanding the genetic implications and potential for recurrence in future pregnancies.

Coding Guidelines

Inclusion Criteria

Use Q10.1 When
  • Follow the official ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of associated conditions and any surgical interventions performed

Exclusion Criteria

Do NOT use Q10.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

67904CPT Code

Repair of ectropion, eyelid

Clinical Scenario

Used when surgical correction is performed for congenital ectropion.

Documentation Requirements

Document the indication for surgery, preoperative assessment, and postoperative care.

Specialty Considerations

Ophthalmology-specific documentation regarding surgical technique and outcomes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes for congenital ectropion and associated anomalies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes for congenital ectropion and associated anomalies.

Reimbursement & Billing Impact

reimbursement processes for congenital ectropion and associated anomalies.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding congenital ectropion accurately?

Accurate coding of congenital ectropion is crucial for ensuring appropriate treatment, follow-up care, and reimbursement. It also aids in tracking congenital conditions for public health data and research purposes.