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ICD-10 Guide
ICD-10 CodesH02.025

H02.025

Billable

Mechanical entropion of left lower eyelid

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

Code Description

ICD-10 H02.025 is a billable code used to indicate a diagnosis of mechanical entropion of left lower eyelid.

Key Diagnostic Point:

Mechanical entropion of the left lower eyelid is characterized by the inward turning of the eyelid margin, which can lead to irritation of the conjunctiva and cornea due to direct contact with the eyelashes. This condition may arise from various factors including age-related changes, scarring, or trauma that affects the eyelid's structural integrity. The anatomy involved includes the eyelid itself, which consists of skin, muscle, and connective tissue, as well as the surrounding periocular structures such as the orbicularis oculi muscle and the tarsal plate. Disease progression can lead to chronic irritation, corneal abrasion, and potential vision impairment if left untreated. Diagnostic considerations include a thorough clinical examination, patient history, and possibly imaging studies to assess the underlying causes of the entropion. Treatment options may involve surgical intervention to correct the eyelid position, along with symptomatic management to alleviate discomfort and prevent complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a thorough clinical evaluation to differentiate from other eyelid disorders.
  • Treatment complexity: Surgical options may be necessary, which require careful planning and follow-up.
  • Documentation requirements: Detailed clinical notes are essential to justify the diagnosis and treatment.
  • Coding specificity: Requires precise coding to ensure accurate representation of the condition.

Audit Risk Factors

  • Common coding errors: Misidentifying the eyelid involved or confusing with other eyelid conditions.
  • Documentation gaps: Incomplete clinical notes that do not fully describe the condition or treatment.
  • 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

Mechanical entropion can significantly affect a patient's quality of life due to discomfort and potential vision impairment. It is essential for healthcare providers to recognize and address this condition promptly to prevent complications such as corneal damage. Understanding the epidemiology of eyelid disorders, including entropion, can inform population health strategies and improve healthcare utilization patterns by promoting timely interventions.

ICD-9 vs ICD-10

Mechanical entropion can significantly affect a patient's quality of life due to discomfort and potential vision impairment. It is essential for healthcare providers to recognize and address this condition promptly to prevent complications such as corneal damage. Understanding the epidemiology of eyelid disorders, including entropion, can inform population health strategies and improve healthcare utilization patterns by promoting timely interventions.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the procedure is deemed medically necessary and that all relevant clinical information is provided to support the claim. Common denials may arise from insufficient documentation or failure to demonstrate the need for surgery. Best practices include maintaining thorough clinical notes and ensuring that all coding aligns with the services rendered.

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 H02.025?

H02.025 specifically covers mechanical entropion of the left lower eyelid, which is characterized by the inward turning of the eyelid due to mechanical factors. It does not cover other forms of entropion such as spastic or cicatricial entropion.

When should H02.025 be used instead of related codes?

H02.025 should be used when the condition specifically involves the left lower eyelid and is due to mechanical causes. It is important to differentiate it from entropion of other eyelids or types of entropion to ensure accurate coding.

What documentation supports H02.025?

Documentation should include a detailed patient history, clinical examination findings, and any imaging studies performed. Notes should clearly describe the mechanical nature of the entropion and any treatment plans proposed.