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ICD-10 Guide
ICD-10 CodesH02.002

H02.002

Billable

Unspecified entropion of right lower eyelid

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

Code Description

ICD-10 H02.002 is a billable code used to indicate a diagnosis of unspecified entropion of right lower eyelid.

Key Diagnostic Point:

Unspecified entropion of the right lower eyelid refers to a condition where the lower eyelid turns inward, causing the eyelashes to rub against the cornea and conjunctiva. This can lead to irritation, discomfort, and potential damage to the ocular surface. The anatomy involved includes the eyelid structures, such as the orbicularis oculi muscle, tarsal plate, and conjunctiva. The condition may arise from age-related changes, scarring, or congenital factors. Disease progression can vary; if left untreated, entropion may lead to chronic irritation, corneal abrasions, and even vision impairment. Diagnostic considerations include a thorough ocular examination, patient history, and assessment of symptoms such as tearing, redness, and foreign body sensation. The condition may be associated with other eyelid disorders, such as ectropion or blepharitis, and requires careful evaluation to determine the underlying cause and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a detailed ocular examination and history to differentiate from other eyelid disorders.
  • Treatment complexity: May involve surgical intervention or conservative management depending on severity.
  • Documentation requirements: Requires precise documentation of symptoms, examination findings, and treatment plans.
  • Coding specificity: Specific to entropion of the right lower eyelid, necessitating accurate coding to avoid misclassification.

Audit Risk Factors

  • Common coding errors: Misidentification of the eyelid involved or confusion with ectropion codes.
  • Documentation gaps: Incomplete patient history or lack of detailed examination notes.
  • Billing challenges: Potential denials if the medical necessity is not clearly established.

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

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 issues. The condition is more prevalent in older populations, making it an important consideration in geriatric care. Understanding the epidemiology of entropion can help healthcare providers implement preventive measures and improve patient outcomes through timely intervention and management.

ICD-9 vs ICD-10

Entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision issues. The condition is more prevalent in older populations, making it an important consideration in geriatric care. Understanding the epidemiology of entropion can help healthcare providers implement preventive measures and improve patient outcomes through timely intervention and management.

Reimbursement & Billing Impact

Reimbursement considerations include the need for a comprehensive examination and potential surgical intervention. Common denials may arise if the documentation does not clearly establish the diagnosis or if the treatment is deemed not medically necessary. Best practices include maintaining thorough records of patient interactions, treatment plans, and follow-up assessments 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 H02.002?

H02.002 covers unspecified entropion of the right lower eyelid, which may be due to age-related changes, scarring, or congenital factors. It does not specify the underlying cause, allowing for broader application in clinical settings.

When should H02.002 be used instead of related codes?

H02.002 should be used when the entropion is specifically affecting the right lower eyelid and the cause is not clearly defined. If the condition is associated with other eyelid disorders or if the left eyelid is involved, other codes should be considered.

What documentation supports H02.002?

Documentation should include a detailed ocular examination, patient symptoms, history of eyelid issues, and any previous treatments. Clear notes on the condition's impact on the patient's quality of life and visual function are also essential.