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ICD-10 Guide
ICD-10 CodesH01.006

H01.006

Billable

Unspecified blepharitis left eye, unspecified eyelid

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

Code Description

ICD-10 H01.006 is a billable code used to indicate a diagnosis of unspecified blepharitis left eye, unspecified eyelid.

Key Diagnostic Point:

Unspecified blepharitis of the left eye, unspecified eyelid, refers to inflammation of the eyelid margins that can present with symptoms such as redness, swelling, crusting, and irritation. The condition may arise from seborrheic dermatitis, staphylococcal infection, or meibomian gland dysfunction. The eyelids are composed of skin, muscle, and connective tissue, and they play a crucial role in protecting the eye and maintaining tear film stability. Disease progression can lead to chronic irritation, potential eyelash loss, and secondary infections if left untreated. Diagnostic considerations include a thorough history and physical examination, often supplemented by slit-lamp examination to assess the extent of eyelid involvement and rule out other conditions. Management typically involves eyelid hygiene, warm compresses, and topical antibiotics or corticosteroids as needed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires differentiation from other eyelid conditions.
  • Treatment complexity: Moderate, involving both conservative and pharmacological approaches.
  • Documentation requirements: Moderate, necessitating detailed clinical notes and treatment plans.
  • Coding specificity: Medium, as it specifies the laterality but not the type of blepharitis.

Audit Risk Factors

  • Common coding errors: Misidentifying the type of blepharitis or failing to specify laterality.
  • Documentation gaps: Incomplete records regarding symptoms or treatment plans.
  • Billing challenges: Potential denials due to lack of specificity or insufficient clinical justification.

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

Blepharitis, including unspecified types like H01.006, can significantly impact patient quality of life, leading to discomfort and visual disturbances. Its prevalence in the population highlights the need for effective management strategies. Understanding the epidemiology of blepharitis can aid in developing public health initiatives aimed at reducing its incidence and improving overall ocular health.

ICD-9 vs ICD-10

Blepharitis, including unspecified types like H01.006, can significantly impact patient quality of life, leading to discomfort and visual disturbances. Its prevalence in the population highlights the need for effective management strategies. Understanding the epidemiology of blepharitis can aid in developing public health initiatives aimed at reducing its incidence and improving overall ocular health.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis aligns with the services rendered. Common denials may arise from insufficient documentation or lack of specificity in the diagnosis. Best practices include maintaining comprehensive clinical notes and ensuring that the treatment plan is clearly articulated to support the medical necessity of the billed services.

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 H01.006?

H01.006 covers unspecified blepharitis, which may include various forms of eyelid inflammation without specific etiological classification. It encompasses conditions that lead to eyelid irritation and inflammation but does not specify the underlying cause.

When should H01.006 be used instead of related codes?

H01.006 should be used when the clinician has determined that the patient has blepharitis affecting the left eyelid but has not specified the type or cause. It is appropriate when more specific codes (e.g., H01.001 for staphylococcal blepharitis) do not apply.

What documentation supports H01.006?

Documentation should include a detailed history of symptoms, physical examination findings, treatment plans, and any diagnostic tests performed. Clear notes on the patient's response to treatment and follow-up care are also essential.