ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesH02.046

H02.046

Billable

Spastic entropion of left eye, unspecified eyelid

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

Code Description

ICD-10 H02.046 is a billable code used to indicate a diagnosis of spastic entropion of left eye, unspecified eyelid.

Key Diagnostic Point:

Spastic entropion of the left eye, unspecified eyelid, is characterized by an involuntary spasm of the eyelid muscles, leading to inward turning of the eyelid margin. This condition can cause the eyelashes to rub against the cornea, resulting in irritation, redness, and potential damage to the ocular surface. The anatomy involved includes the orbicularis oculi muscle, which controls eyelid movement, and the surrounding periocular structures such as the conjunctiva and cornea. Disease progression may vary; if untreated, spastic entropion can lead to chronic discomfort, corneal abrasions, and even vision impairment. Diagnostic considerations include a thorough clinical examination, patient history, and possibly imaging studies to rule out underlying conditions such as blepharospasm or other eyelid malpositions. Treatment options may include botulinum toxin injections to alleviate muscle spasms or surgical intervention for persistent cases. Proper diagnosis and management are crucial to prevent complications and ensure optimal ocular health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other eyelid disorders such as involutional entropion or blepharospasm.
  • Treatment complexity: May involve both non-surgical and surgical interventions depending on severity.
  • Documentation requirements: Detailed clinical notes and patient history are essential for accurate coding.
  • Coding specificity: Requires precise coding to capture the specific eyelid involved and the nature of the condition.

Audit Risk Factors

  • Common coding errors: Misidentifying the eyelid involved or confusing with other eyelid disorders.
  • Documentation gaps: Incomplete clinical notes may lead to incorrect coding or denials.
  • Billing challenges: Potential for denials if the medical necessity for treatment is not well-documented.

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

Optometry

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

Spastic entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision issues. Understanding the epidemiology of this condition is crucial, as it may be more prevalent in certain populations, particularly the elderly. Effective management can reduce healthcare utilization by preventing complications such as corneal abrasions and subsequent treatments. Quality measures should focus on timely diagnosis and intervention to enhance patient outcomes.

ICD-9 vs ICD-10

Spastic entropion can significantly affect a patient's quality of life, leading to discomfort and potential vision issues. Understanding the epidemiology of this condition is crucial, as it may be more prevalent in certain populations, particularly the elderly. Effective management can reduce healthcare utilization by preventing complications such as corneal abrasions and subsequent treatments. Quality measures should focus on timely diagnosis and intervention to enhance patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the procedure performed is medically necessary and supported by clinical evidence. Common denials may arise from insufficient documentation or failure to demonstrate the necessity of surgical intervention. Best practices include maintaining thorough records of patient visits, treatment responses, and any consultations with specialists to substantiate the need for procedures related to spastic entropion.

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 H02.046?

H02.046 specifically covers spastic entropion of the left eye, where the eyelid turns inward due to muscle spasms. It is important to differentiate this from other forms of entropion and eyelid disorders.

When should H02.046 be used instead of related codes?

H02.046 should be used when the condition specifically involves spastic entropion of the left eyelid. If the right eyelid is affected or if the entropion is due to other causes, different codes should be selected.

What documentation supports H02.046?

Documentation should include a detailed clinical examination, patient history indicating symptoms such as irritation or discomfort, and any previous treatments attempted. Photographic evidence may also be beneficial.