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ICD-10 Guide
ICD-10 CodesH02.00

H02.00

Non-billable

Unspecified entropion of eyelid

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

Code Description

ICD-10 H02.00 is a used to indicate a diagnosis of unspecified entropion of eyelid.

Key Diagnostic Point:

Unspecified entropion of the eyelid is a condition characterized by the inward turning of the eyelid margin, which can lead to irritation of the conjunctiva and cornea due to the eyelashes rubbing against the ocular surface. The eyelids consist of several anatomical components, including the skin, muscle, and connective tissue, all of which can be affected by entropion. This condition can occur in both the upper and lower eyelids and may be associated with age-related changes, scarring, or congenital factors. Patients typically present with symptoms such as redness, tearing, discomfort, and potential vision impairment if left untreated. Disease progression can lead to chronic irritation and corneal damage, necessitating timely intervention. Diagnostic considerations include a thorough ocular examination, patient history, and assessment of eyelid function. Treatment options range from conservative management, such as lubricating eye drops, to surgical correction in more severe cases. Accurate diagnosis and coding are essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a detailed ocular examination and understanding of eyelid anatomy.
  • Treatment complexity: May involve both conservative and surgical interventions.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis.
  • Coding specificity: Requires differentiation from other eyelid disorders such as ectropion or blepharospasm.

Audit Risk Factors

  • Common coding errors: Misclassification with other eyelid conditions.
  • Documentation gaps: Incomplete patient history or examination findings.
  • Billing challenges: Potential denials due to lack of specificity in coding.

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

Plastic Surgery

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

Entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision loss. Understanding the epidemiology of this condition is crucial, as it is more prevalent in older populations due to age-related changes in eyelid structure. Effective management can reduce healthcare utilization by preventing complications such as corneal abrasions or infections, thereby improving overall patient outcomes.

ICD-9 vs ICD-10

Entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision loss. Understanding the epidemiology of this condition is crucial, as it is more prevalent in older populations due to age-related changes in eyelid structure. Effective management can reduce healthcare utilization by preventing complications such as corneal abrasions or infections, thereby improving overall patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, the setting in which care is delivered, and the patient's insurance coverage. Common denials may arise from insufficient documentation or lack of specificity in coding. Best practices include ensuring that all clinical notes are complete and that the rationale for any surgical intervention is clearly articulated in the medical record.

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 H02.00?

H02.00 covers unspecified entropion of the eyelid, which may not be clearly defined as congenital or acquired. It includes cases where the exact cause of the inward turning of the eyelid is not documented.

When should H02.00 be used instead of related codes?

H02.00 should be used when the specific eyelid affected is not documented, or when the entropion is not classified as right or left. If the condition is specified, related codes such as H02.01 or H02.02 should be used.

What documentation supports H02.00?

Documentation should include a comprehensive ocular examination, patient symptoms, and any relevant history of eyelid disorders. Clear notes on the clinical findings and treatment plan are essential.