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ICD-10 Guide
ICD-10 CodesH02.024

H02.024

Billable

Mechanical entropion of left upper eyelid

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

Code Description

ICD-10 H02.024 is a billable code used to indicate a diagnosis of mechanical entropion of left upper eyelid.

Key Diagnostic Point:

Mechanical entropion of the left upper eyelid is characterized by the inward turning of the eyelid margin, leading to irritation of the conjunctiva and cornea due to direct contact with the eyelashes. This condition can arise from various factors, including age-related changes, scarring, or anatomical abnormalities affecting the eyelid's support structures. The eyelid anatomy involved includes the orbicularis oculi muscle, tarsal plate, and the skin surrounding the eyelid. As the condition progresses, patients may experience symptoms such as redness, tearing, and discomfort, which can significantly impact their quality of life. Diagnosis typically involves a thorough clinical examination, including visual acuity tests and assessment of eyelid position and function. Differential diagnoses may include other forms of entropion, such as spastic or cicatricial entropion, necessitating careful evaluation to determine the appropriate management strategy. Treatment options may range from conservative measures, such as lubricating eye drops, to surgical intervention aimed at correcting the eyelid position and alleviating symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a thorough clinical examination and differentiation from other eyelid disorders.
  • Treatment complexity: May involve both non-surgical and surgical options depending on severity.
  • Documentation requirements: Detailed documentation of symptoms, examination findings, and treatment plans is essential.
  • Coding specificity: Requires precise coding to differentiate from other types of entropion.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of entropion or incorrect coding of the eyelid involved.
  • Documentation gaps: Incomplete records regarding the patient's symptoms and treatment history.
  • Billing challenges: Potential denials if documentation does not support the medical necessity of the procedure.

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 patients' quality of life, leading to discomfort and potential vision problems. Understanding the epidemiology of this condition is important, as it is more prevalent in older populations. Addressing entropion can improve patient outcomes and reduce healthcare utilization by preventing complications such as corneal abrasions or infections.

ICD-9 vs ICD-10

Mechanical entropion can significantly affect patients' quality of life, leading to discomfort and potential vision problems. Understanding the epidemiology of this condition is important, as it is more prevalent in older populations. Addressing entropion can improve patient outcomes and reduce healthcare utilization by preventing complications such as corneal abrasions or infections.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the medical necessity of any surgical procedures performed. Common denials may occur if the documentation does not adequately reflect the severity of the condition or if the procedure is deemed not medically necessary. Best practices include maintaining thorough records of patient evaluations, treatment plans, and follow-up care 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 H02.024?

H02.024 specifically covers mechanical entropion of the left upper eyelid, which is caused by structural issues leading to the inward turning of the eyelid. It does not cover other types of entropion such as spastic or cicatricial entropion.

When should H02.024 be used instead of related codes?

H02.024 should be used when the diagnosis is specifically mechanical entropion of the left upper eyelid. If the entropion is due to other causes, such as spastic or cicatricial, then the appropriate codes for those conditions should be selected.

What documentation supports H02.024?

Documentation should include a detailed history of the patient's symptoms, results from a comprehensive eye examination, and any previous treatments attempted. Photographic evidence may also be beneficial in illustrating the condition.