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ICD-10 Guide
ICD-10 CodesH01.023

H01.023

Billable

Squamous blepharitis right eye, unspecified eyelid

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

Code Description

ICD-10 H01.023 is a billable code used to indicate a diagnosis of squamous blepharitis right eye, unspecified eyelid.

Key Diagnostic Point:

H01.023 refers to squamous blepharitis affecting the right eye, specifically the unspecified eyelid. This condition is characterized by inflammation of the eyelid margins, leading to crusting, redness, and irritation. Clinically, patients may present with symptoms such as itching, burning, and a gritty sensation in the eye. The anatomy involved includes the eyelid structures, such as the skin, meibomian glands, and eyelashes, which can become obstructed or inflamed due to the accumulation of debris and bacteria. Disease progression may lead to chronic irritation and potential complications, including secondary infections or conjunctivitis if left untreated. Diagnostic considerations include a thorough patient history, physical examination of the eyelids, and possibly the use of slit-lamp biomicroscopy to assess the severity of the condition. Treatment typically involves eyelid hygiene, warm compresses, and topical antibiotics or corticosteroids if necessary. Regular follow-up is essential to monitor the condition and prevent recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires differentiation from other eyelid disorders.
  • Treatment complexity: Moderate, involving both conservative and pharmacological management.
  • Documentation requirements: Moderate, necessitating detailed clinical notes and treatment plans.
  • Coding specificity: High, as it specifies the eye and eyelid involved.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected eyelid or confusion with other forms of blepharitis.
  • Documentation gaps: Incomplete clinical notes regarding symptomatology and treatment response.
  • Billing challenges: Potential denials due to lack of specificity or insufficient documentation.

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 impact patient quality of life due to discomfort and visual disturbances. It is prevalent in various populations, particularly among individuals with skin conditions or poor eyelid hygiene. Understanding the epidemiology of this condition can help healthcare providers implement effective preventive measures and improve patient education on eyelid care. Quality measures may include tracking treatment outcomes and patient satisfaction related to eyelid health.

ICD-9 vs ICD-10

Squamous blepharitis can significantly impact patient quality of life due to discomfort and visual disturbances. It is prevalent in various populations, particularly among individuals with skin conditions or poor eyelid hygiene. Understanding the epidemiology of this condition can help healthcare providers implement effective preventive measures and improve patient education on eyelid care. Quality measures may include tracking treatment outcomes and patient satisfaction related to eyelid health.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for ophthalmological services and ensuring that the procedure codes align with the diagnosis. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining thorough clinical notes, using appropriate modifiers when necessary, and ensuring that all billing codes are up-to-date with current coding guidelines.

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 H01.023?

H01.023 specifically covers squamous blepharitis of the right eyelid, which is characterized by scaling, crusting, and inflammation of the eyelid margins. It is important to differentiate this from other types of blepharitis, such as seborrheic or ulcerative blepharitis.

When should H01.023 be used instead of related codes?

H01.023 should be used when the condition is specifically diagnosed as squamous blepharitis affecting the right eyelid. If the left eyelid is involved, or if the condition is of a different type, the appropriate code should be selected.

What documentation supports H01.023?

Documentation should include a detailed history of symptoms, physical examination findings, treatment plans, and any follow-up assessments. Specific notes on the appearance of the eyelid margins and response to treatment are essential.