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ICD-10 Guide
ICD-10 CodesH01.01

H01.01

Non-billable

Ulcerative blepharitis

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

Code Description

ICD-10 H01.01 is a used to indicate a diagnosis of ulcerative blepharitis.

Key Diagnostic Point:

Ulcerative blepharitis is a chronic inflammatory condition affecting the eyelid margins, characterized by the presence of crusted debris, erythema, and ulceration. This condition primarily involves the periocular anatomy, including the eyelids and associated structures such as the meibomian glands, which can become obstructed, leading to further inflammation and discomfort. Clinically, patients may present with symptoms such as itching, burning, and foreign body sensation in the eyes, along with potential eyelash loss and conjunctival irritation. The disease can progress to more severe complications, including keratitis 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 such as seborrheic dermatitis or staphylococcal infections. Management typically involves eyelid hygiene, warm compresses, and topical antibiotics or corticosteroids to reduce inflammation and promote healing.

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 misclassification with non-ulcerative forms of blepharitis.
  • Documentation gaps may arise if the extent of eyelid involvement is not clearly noted.
  • Billing challenges can occur if the treatment plan is not adequately documented.

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

Ulcerative blepharitis can significantly impact patient quality of life due to discomfort and potential vision impairment. It is a common condition that may lead to increased healthcare utilization, including visits to ophthalmologists and dermatologists. Understanding its epidemiological trends can help in developing preventive strategies and improving patient outcomes through timely intervention.

ICD-9 vs ICD-10

Ulcerative blepharitis can significantly impact patient quality of life due to discomfort and potential vision impairment. It is a common condition that may lead to increased healthcare utilization, including visits to ophthalmologists and dermatologists. Understanding its epidemiological trends can help in developing preventive strategies and improving patient outcomes through timely intervention.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the severity of the condition and the complexity of the treatment provided. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include thorough documentation of symptoms, treatment responses, and follow-up care to ensure compliance with payer requirements.

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 H01.01?

H01.01 specifically covers ulcerative blepharitis, which may be associated with staphylococcal infections or seborrheic dermatitis. It is characterized by ulceration and crusting along the eyelid margins.

When should H01.01 be used instead of related codes?

H01.01 should be used when there is clear evidence of ulceration and inflammation of the eyelid margins. It is important to differentiate it from non-ulcerative forms of blepharitis, which would fall under different codes.

What documentation supports H01.01?

Documentation should include a detailed clinical examination noting the presence of ulceration, crusting, and any associated symptoms. Treatment plans and follow-up notes should also be included to support the diagnosis.