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ICD-10 Guide
ICD-10 CodesH02.022

H02.022

Billable

Mechanical entropion of right lower eyelid

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

Code Description

ICD-10 H02.022 is a billable code used to indicate a diagnosis of mechanical entropion of right lower eyelid.

Key Diagnostic Point:

Mechanical entropion of the right lower eyelid is characterized by the inward turning of the eyelid margin, leading to the lashes rubbing against the cornea and conjunctiva. This condition can result from various factors, including age-related changes, scarring, or trauma, which may alter the normal anatomy of the eyelid. The lower eyelid anatomy includes the skin, muscle (orbicularis oculi), and the tarsal plate, which provides structural support. As the condition progresses, patients may experience symptoms such as irritation, redness, tearing, and potential corneal abrasion or ulceration due to the constant friction. Diagnosis typically involves a thorough ocular examination, including visual acuity tests and slit-lamp examination to assess the extent of eyelid malposition and any resultant ocular surface damage. Treatment options may include surgical intervention to correct the eyelid position, along with addressing any underlying causes. Proper diagnosis and management are crucial to prevent complications such as chronic discomfort or vision impairment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough ocular examination and assessment of eyelid anatomy.
  • Treatment complexity: May involve surgical correction and post-operative care.
  • Documentation requirements: Detailed clinical notes and history of symptoms are essential.
  • Coding specificity: Requires precise coding to differentiate from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misidentification of the eyelid involved or confusion with other eyelid conditions.
  • Documentation gaps: Incomplete clinical notes regarding the patient's history and examination findings.
  • Billing challenges: Potential denials if the medical necessity for surgical intervention is not clearly documented.

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

Mechanical entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision issues. Understanding the epidemiology of eyelid disorders is crucial for healthcare providers, as these conditions can impact a wide demographic, particularly the elderly. Effective management of entropion can reduce healthcare utilization by preventing complications such as corneal abrasions, thereby improving overall patient outcomes.

ICD-9 vs ICD-10

Mechanical entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision issues. Understanding the epidemiology of eyelid disorders is crucial for healthcare providers, as these conditions can impact a wide demographic, particularly the elderly. Effective management of entropion can reduce healthcare utilization by preventing complications such as corneal abrasions, thereby improving overall patient outcomes.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the procedure and the patient's insurance plan. Common denials can occur if the documentation does not clearly establish the diagnosis and the need for intervention. Coders should ensure that all relevant clinical notes, including pre-operative assessments and post-operative care, are included in the patient's medical record to support the claim.

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 H02.022?

H02.022 specifically covers mechanical entropion of the right lower eyelid, which may arise from scarring, age-related changes, or trauma. It is important to differentiate this from other forms of entropion, such as spastic or involutional entropion.

When should H02.022 be used instead of related codes?

H02.022 should be used when the condition specifically involves the mechanical entropion of the right lower eyelid. If the left eyelid is affected, or if the entropion is due to other causes, different codes should be selected.

What documentation supports H02.022?

Documentation should include a detailed history of the patient's symptoms, results from a comprehensive eye examination, and any imaging studies if applicable. Surgical notes and post-operative assessments are also critical if surgical intervention is performed.