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ICD-10 Guide
ICD-10 CodesH02.03

H02.03

Non-billable

Senile entropion of eyelid

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

Code Description

ICD-10 H02.03 is a used to indicate a diagnosis of senile entropion of eyelid.

Key Diagnostic Point:

Senile entropion of the eyelid is a condition characterized by the inward turning of the eyelid margin, often seen in older adults due to age-related changes in the eyelid's structural integrity. The condition primarily affects the lower eyelid and can lead to irritation, corneal abrasion, and potential vision impairment if left untreated. 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 lacrimal glands and the orbital cavity. Disease progression typically involves gradual weakening of the eyelid's support structures, leading to the characteristic inward folding. Diagnostic considerations include a thorough clinical examination, patient history, and assessment of symptoms such as tearing, redness, and discomfort. In some cases, additional imaging may be warranted to evaluate the extent of the condition and rule out other ocular disorders.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires clinical examination and patient history.
  • Treatment complexity: Moderate, as surgical intervention may be necessary.
  • Documentation requirements: Requires detailed clinical notes and symptom descriptions.
  • Coding specificity: Specific to senile entropion, but must differentiate from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misclassification with other types of entropion.
  • Documentation gaps: Incomplete patient history or symptom descriptions.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis.

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

Dermatology

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

Senile entropion significantly impacts patient quality of life, leading to discomfort and potential vision issues. It is prevalent in the aging population, making it a relevant concern for public health. Effective management can reduce healthcare utilization by preventing complications such as corneal damage. Awareness and early intervention are crucial for maintaining ocular health in older adults.

ICD-9 vs ICD-10

Senile entropion significantly impacts patient quality of life, leading to discomfort and potential vision issues. It is prevalent in the aging population, making it a relevant concern for public health. Effective management can reduce healthcare utilization by preventing complications such as corneal damage. Awareness and early intervention are crucial for maintaining ocular health in older adults.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the procedure and the payer's policies. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include ensuring that all relevant details are included in the medical record and that the coding accurately reflects the diagnosis and treatment provided.

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 H02.03?

H02.03 specifically covers senile entropion, which is the involutional inward turning of the eyelid due to aging. It does not include other forms of entropion such as congenital or spastic entropion.

When should H02.03 be used instead of related codes?

H02.03 should be used when the entropion is specifically due to senile changes. If the entropion is due to other causes, such as spasticity or congenital factors, other codes should be selected.

What documentation supports H02.03?

Documentation should include a detailed clinical examination, patient history indicating age-related changes, and descriptions of symptoms such as irritation or tearing. Surgical notes may also be required if corrective procedures are performed.