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ICD-10 Guide
ICD-10 CodesH01.115

H01.115

Billable

Allergic dermatitis of left lower eyelid

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

Code Description

ICD-10 H01.115 is a billable code used to indicate a diagnosis of allergic dermatitis of left lower eyelid.

Key Diagnostic Point:

Allergic dermatitis of the left lower eyelid is characterized by an inflammatory response of the skin surrounding the eyelid due to exposure to allergens. Clinically, patients may present with symptoms such as redness, swelling, itching, and scaling of the affected eyelid. The periocular anatomy includes the eyelids, conjunctiva, and surrounding skin, which are crucial for protecting the eye and maintaining its health. The lacrimal system, responsible for tear production and drainage, may also be indirectly affected by dermatitis, leading to discomfort or excessive tearing. Disease progression can vary; acute allergic reactions may resolve quickly with avoidance of the allergen, while chronic dermatitis may require ongoing management. Diagnostic considerations include a thorough patient history to identify potential allergens, physical examination, and possibly patch testing to confirm specific sensitivities. Accurate diagnosis is essential to differentiate allergic dermatitis from other eyelid disorders such as atopic dermatitis or contact dermatitis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires identification of allergens and differentiation from other conditions.
  • Treatment complexity: May involve topical corticosteroids, antihistamines, and allergen avoidance.
  • Documentation requirements: Detailed patient history and clinical findings are necessary.
  • Coding specificity: Specific to allergic dermatitis of the left lower eyelid, requiring precise coding.

Audit Risk Factors

  • Common coding errors: Misidentification of the eyelid affected or misclassification of dermatitis type.
  • Documentation gaps: Incomplete patient history or lack of allergen identification.
  • 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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Allergic dermatitis of the eyelid can significantly affect patients' quality of life, leading to discomfort and potential complications such as secondary infections. Understanding the epidemiology of allergic dermatitis is crucial, as it can affect a substantial portion of the population, particularly those with atopic conditions. Quality measures may include tracking the incidence of allergic reactions and the effectiveness of treatment protocols, which can inform healthcare utilization patterns and resource allocation.

ICD-9 vs ICD-10

Allergic dermatitis of the eyelid can significantly affect patients' quality of life, leading to discomfort and potential complications such as secondary infections. Understanding the epidemiology of allergic dermatitis is crucial, as it can affect a substantial portion of the population, particularly those with atopic conditions. Quality measures may include tracking the incidence of allergic reactions and the effectiveness of treatment protocols, which can inform healthcare utilization patterns and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis aligns with the services provided. Common denials may arise from insufficient documentation or lack of specificity in the diagnosis. Best practices include maintaining thorough records of patient interactions, treatment responses, and follow-up care to support claims. Additionally, coders should ensure that the CPT codes used for procedures align with the diagnosis to avoid discrepancies during the billing process.

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 H01.115?

H01.115 specifically covers allergic dermatitis localized to the left lower eyelid, which may arise from various allergens such as cosmetics, medications, or environmental factors.

When should H01.115 be used instead of related codes?

H01.115 should be used when the allergic dermatitis is confirmed to be localized to the left lower eyelid, differentiating it from other eyelid dermatitis codes that may involve different locations or etiologies.

What documentation supports H01.115?

Documentation should include a detailed patient history indicating exposure to potential allergens, clinical findings from the examination, and any diagnostic tests performed, such as patch testing.