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ICD-10 Guide
ICD-10 CodesH02.034

H02.034

Billable

Senile entropion of left upper eyelid

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

Code Description

ICD-10 H02.034 is a billable code used to indicate a diagnosis of senile entropion of left upper eyelid.

Key Diagnostic Point:

Senile entropion of the left upper eyelid is a condition characterized by the inward turning of the eyelid margin, leading to potential irritation of the cornea and conjunctiva. This condition is commonly seen in elderly patients due to age-related changes in the eyelid's structural integrity, including laxity of the eyelid skin and weakening of the supporting tissues. The left upper eyelid specifically may exhibit symptoms such as redness, tearing, and discomfort, which can significantly affect the patient's quality of life. The anatomy involved includes the eyelid, orbicularis oculi muscle, and the surrounding periocular structures. Disease progression can lead to chronic irritation, corneal abrasions, and even vision impairment if left untreated. Diagnostic considerations include a thorough clinical examination, patient history, and possibly imaging studies to assess the extent of the entropion and any associated complications. Treatment often involves surgical intervention to correct the eyelid position and alleviate symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and differentiation from other eyelid disorders.
  • Treatment complexity: Surgical options may vary based on severity and patient health.
  • Documentation requirements: Detailed clinical notes are necessary to support diagnosis and treatment.
  • Coding specificity: Requires precise coding to differentiate from other types of entropion.

Audit Risk Factors

  • Common coding errors: Misclassification of entropion type or eyelid location.
  • Documentation gaps: Incomplete patient history or lack of detailed examination notes.
  • Billing challenges: Potential denials if surgical procedures are not adequately justified.

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

Geriatrics

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 can significantly impact the quality of life for elderly patients, leading to discomfort and potential vision problems. Understanding the prevalence of this condition can help healthcare providers implement preventive measures and improve patient outcomes. By addressing this common issue, healthcare systems can enhance patient satisfaction and reduce the burden on ophthalmology services.

ICD-9 vs ICD-10

Senile entropion can significantly impact the quality of life for elderly patients, leading to discomfort and potential vision problems. Understanding the prevalence of this condition can help healthcare providers implement preventive measures and improve patient outcomes. By addressing this common issue, healthcare systems can enhance patient satisfaction and reduce the burden on ophthalmology services.

Reimbursement & Billing Impact

Senile entropion can significantly impact the quality of life for elderly patients, leading to discomfort and potential vision problems. Understanding the prevalence of this condition can help healthcare providers implement preventive measures and improve patient outcomes. By addressing this common issue, healthcare systems can enhance patient satisfaction and reduce the burden on ophthalmology services.

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 H02.034?

H02.034 specifically covers senile entropion of the left upper eyelid, which is characterized by the inward turning of the eyelid due to age-related changes. It does not cover entropion caused by trauma or other underlying conditions.

When should H02.034 be used instead of related codes?

H02.034 should be used when the diagnosis specifically involves senile entropion of the left upper eyelid. If the entropion affects other eyelids or is of a different etiology, other codes should be selected accordingly.

What documentation supports H02.034?

Documentation should include a comprehensive eye examination, patient history indicating age-related changes, and any symptoms reported by the patient. Surgical notes and treatment plans should also be included to support the coding.