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ICD-10 Guide
ICD-10 CodesH02.029

H02.029

Billable

Mechanical entropion of unspecified eye, unspecified eyelid

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

Code Description

ICD-10 H02.029 is a billable code used to indicate a diagnosis of mechanical entropion of unspecified eye, unspecified eyelid.

Key Diagnostic Point:

Mechanical entropion of the unspecified eye and unspecified eyelid is 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. This condition can arise from various factors, including age-related changes, scarring, or trauma to the eyelid. The anatomy involved includes the eyelids, which serve as protective barriers for the eyes, and the surrounding periocular structures, including the lacrimal glands that produce tears for lubrication. Disease progression may lead to chronic irritation, corneal abrasions, and potential vision impairment if left untreated. Diagnostic considerations involve a thorough ocular examination, including assessment of eyelid position, eyelash orientation, and any associated symptoms such as redness, tearing, or discomfort. The diagnosis may be confirmed through patient history and clinical findings, often necessitating referral to an ophthalmologist for further evaluation and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and differentiation from other eyelid disorders.
  • Treatment complexity: May involve surgical intervention or conservative management depending on severity.
  • Documentation requirements: Detailed clinical notes and history are essential for accurate coding.
  • Coding specificity: Requires precise identification of the affected eye and eyelid.

Audit Risk Factors

  • Common coding errors: Misidentification of the eye or eyelid involved.
  • Documentation gaps: Incomplete clinical notes regarding the condition's severity or treatment plan.
  • Billing challenges: Potential denials if the 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

General Practice

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

The clinical significance of mechanical entropion lies in its potential to cause discomfort and visual impairment if untreated. It affects a diverse population, particularly the elderly, and can lead to increased healthcare utilization due to complications such as corneal abrasions. Quality measures may include tracking the incidence of surgical interventions for entropion and patient-reported outcomes post-treatment, highlighting the importance of timely diagnosis and management in improving patient quality of life.

ICD-9 vs ICD-10

The clinical significance of mechanical entropion lies in its potential to cause discomfort and visual impairment if untreated. It affects a diverse population, particularly the elderly, and can lead to increased healthcare utilization due to complications such as corneal abrasions. Quality measures may include tracking the incidence of surgical interventions for entropion and patient-reported outcomes post-treatment, highlighting the importance of timely diagnosis and management in improving patient quality of life.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for treatment is clearly documented. Common denials may arise from insufficient documentation or lack of clarity regarding the specific eyelid affected. Best practices include maintaining thorough clinical notes, using appropriate modifiers when necessary, and ensuring that all coding aligns with the services rendered to avoid billing discrepancies.

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 H02.029?

H02.029 covers mechanical entropion of the unspecified eye and eyelid, which may result from various causes such as aging, trauma, or scarring. It is important to differentiate this from other types of entropion, such as spastic or cicatricial entropion.

When should H02.029 be used instead of related codes?

H02.029 should be used when the specific eye and eyelid affected are not documented. If the condition is localized to a specific eyelid or eye, the corresponding specific code should be utilized.

What documentation supports H02.029?

Documentation should include a detailed patient history, clinical examination findings, and any treatment plans or interventions. Specific notes on the degree of entropion and associated symptoms are crucial for supporting the diagnosis.