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ICD-10 Guide
ICD-10 CodesH01.02

H01.02

Non-billable

Squamous blepharitis

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

Code Description

ICD-10 H01.02 is a used to indicate a diagnosis of squamous blepharitis.

Key Diagnostic Point:

Squamous blepharitis is a common inflammatory condition affecting the eyelids, characterized by the presence of scales and crusts on the eyelid margins. Clinically, patients may present with symptoms such as redness, itching, burning, and a gritty sensation in the eyes. The condition can be associated with seborrheic dermatitis or staphylococcal infections, leading to inflammation of the eyelid margins. The anatomy involved includes the eyelids, which are composed of skin, muscle, and connective tissue, as well as the meibomian glands that secrete oils to maintain tear film stability. Disease progression can lead to chronic irritation, potential scarring, and even complications such as conjunctivitis if left untreated. Diagnostic considerations include a thorough patient history, physical examination of the eyelids, and possibly cultures to rule out infectious causes. Treatment 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 forms of blepharitis.
  • Treatment complexity: Moderate, involving both non-pharmacological and pharmacological approaches.
  • Documentation requirements: Requires detailed clinical notes on symptoms and treatment response.
  • Coding specificity: Specific to squamous blepharitis, but may require additional codes for associated conditions.

Audit Risk Factors

  • Common coding errors: Misclassification with other types of blepharitis.
  • Documentation gaps: Incomplete records of symptoms or treatment plans.
  • Billing challenges: Potential 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

Squamous blepharitis can significantly affect patients' quality of life, leading to discomfort and potential complications if untreated. Understanding its prevalence and management is crucial for improving population health outcomes. Effective treatment can reduce healthcare utilization by minimizing the need for more invasive procedures or treatments. Epidemiologically, blepharitis is common in both adults and children, with varying prevalence based on age and underlying skin conditions.

ICD-9 vs ICD-10

Squamous blepharitis can significantly affect patients' quality of life, leading to discomfort and potential complications if untreated. Understanding its prevalence and management is crucial for improving population health outcomes. Effective treatment can reduce healthcare utilization by minimizing the need for more invasive procedures or treatments. Epidemiologically, blepharitis is common in both adults and children, with varying prevalence based on age and underlying skin conditions.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for ophthalmic conditions. Common denials may arise from insufficient documentation or lack of medical necessity. Coders should ensure that all relevant symptoms and treatment plans are documented in the patient's medical record to support the claim. Best practices include using specific codes for associated conditions and maintaining clear communication with payers regarding coverage policies.

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 H01.02?

H01.02 specifically covers squamous blepharitis, which may be associated with seborrheic dermatitis and other inflammatory skin conditions affecting the eyelids.

When should H01.02 be used instead of related codes?

H01.02 should be used when the clinical presentation is consistent with squamous blepharitis, characterized by scaling and crusting, rather than other types of blepharitis such as staphylococcal or allergic blepharitis.

What documentation supports H01.02?

Documentation should include a detailed history of symptoms, physical examination findings, treatment plans, and any response to therapy. Photographic evidence may also be beneficial.