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ICD-10 Guide
ICD-10 CodesH01.014

H01.014

Billable

Ulcerative blepharitis left upper eyelid

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

Code Description

ICD-10 H01.014 is a billable code used to indicate a diagnosis of ulcerative blepharitis left upper eyelid.

Key Diagnostic Point:

Ulcerative blepharitis of the left upper eyelid is characterized by inflammation and ulceration of the eyelid margins, often presenting with symptoms such as redness, swelling, crusting, and discharge. The condition primarily affects the periocular anatomy, including the eyelid skin, eyelashes, and meibomian glands, which are crucial for maintaining tear film stability. The disease can progress from mild irritation to severe inflammation, leading to potential complications such as eyelid scarring or loss of eyelashes. Diagnosis typically involves a thorough clinical examination, including inspection of the eyelid margins and assessment of associated symptoms. Diagnostic considerations may include differentiating ulcerative blepharitis from other eyelid disorders such as seborrheic dermatitis or staphylococcal blepharitis. Treatment often involves proper eyelid hygiene, topical antibiotics, and anti-inflammatory medications, with the goal of alleviating symptoms and preventing recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other eyelid conditions.
  • Treatment complexity: May involve multiple treatment modalities.
  • Documentation requirements: Detailed clinical notes are necessary.
  • Coding specificity: Requires precise coding to capture the specific location and type of blepharitis.

Audit Risk Factors

  • Common coding errors: Misidentifying the side of the eyelid affected.
  • Documentation gaps: Incomplete clinical notes may lead to coding inaccuracies.
  • Billing challenges: Potential for denials if documentation does not support the diagnosis.

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, leading to discomfort and potential vision issues if left untreated. It is essential for healthcare providers to recognize and manage this condition effectively to reduce healthcare utilization and improve patient outcomes. Epidemiologically, blepharitis is common, particularly in older adults, and understanding its prevalence can help in developing targeted prevention and treatment strategies.

ICD-9 vs ICD-10

Ulcerative blepharitis can significantly impact patient quality of life, leading to discomfort and potential vision issues if left untreated. It is essential for healthcare providers to recognize and manage this condition effectively to reduce healthcare utilization and improve patient outcomes. Epidemiologically, blepharitis is common, particularly in older adults, and understanding its prevalence can help in developing targeted prevention and treatment strategies.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the treatment provided. Common denials may occur if the documentation does not adequately reflect the severity of the condition or if the procedure codes do not align with the diagnosis. Best practices include thorough documentation of clinical findings, treatment plans, and patient responses to therapy to support claims.

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 H01.014?

H01.014 specifically covers ulcerative blepharitis affecting the left upper eyelid, characterized by inflammation and ulceration of the eyelid margin. It may be associated with bacterial infections, seborrheic dermatitis, or other inflammatory conditions.

When should H01.014 be used instead of related codes?

H01.014 should be used when the clinical presentation specifically indicates ulcerative blepharitis localized to the left upper eyelid. It is essential to differentiate it from other types of blepharitis or eyelid disorders to ensure accurate coding.

What documentation supports H01.014?

Documentation should include a detailed clinical examination of the eyelid, description of symptoms, treatment provided, and any relevant history of similar conditions. Photographic evidence may also support the diagnosis.