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ICD-10 Guide
ICD-10 CodesH02.052

H02.052

Billable

Trichiasis without entropion right lower eyelid

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

Code Description

ICD-10 H02.052 is a billable code used to indicate a diagnosis of trichiasis without entropion right lower eyelid.

Key Diagnostic Point:

Trichiasis without entropion of the right lower eyelid is a condition characterized by the misdirection of eyelashes towards the eyeball, leading to potential irritation and damage to the cornea and conjunctiva. The eyelid anatomy involved includes the lower eyelid margin, where the eyelashes are situated, and the surrounding periocular structures, including the conjunctiva and cornea. Patients may present with symptoms such as discomfort, tearing, and redness due to the constant irritation caused by the misaligned lashes. Disease progression can lead to chronic conjunctivitis or corneal abrasion if left untreated. Diagnosis typically involves a thorough ocular examination, including inspection of the eyelid margins and assessment of any associated symptoms. Treatment options may include epilation of the misdirected lashes, cryotherapy, or surgical intervention in more severe cases. Proper diagnosis and management are crucial to prevent complications that can arise from prolonged irritation of the ocular surface.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful examination and differentiation from other eyelid disorders.
  • Treatment complexity: May involve multiple treatment modalities depending on severity.
  • Documentation requirements: Detailed clinical notes are necessary to justify the diagnosis and treatment.
  • Coding specificity: Requires precise coding to differentiate from similar conditions.

Audit Risk Factors

  • Common coding errors: Misidentifying the condition as entropion.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment rationale.
  • Billing challenges: Potential denials if documentation does not 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

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Trichiasis can significantly impact patient quality of life due to discomfort and potential vision complications. Understanding the prevalence of this condition is crucial for population health, as it may lead to increased healthcare utilization due to associated complications. Effective management of trichiasis can improve patient outcomes and reduce the burden on healthcare systems by preventing more severe ocular conditions.

ICD-9 vs ICD-10

Trichiasis can significantly impact patient quality of life due to discomfort and potential vision complications. Understanding the prevalence of this condition is crucial for population health, as it may lead to increased healthcare utilization due to associated complications. Effective management of trichiasis can improve patient outcomes and reduce the burden on healthcare systems by preventing more severe ocular conditions.

Reimbursement & Billing Impact

Reimbursement considerations include verifying that the treatment provided aligns with the diagnosis and that all necessary documentation is submitted. Common denials may arise from insufficient clinical notes or failure to demonstrate medical necessity for the procedure performed. Best practices include maintaining thorough records of patient history, symptoms, and treatment outcomes to support claims.

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 H02.052?

H02.052 specifically covers trichiasis of the right lower eyelid without associated entropion. It is important to differentiate this condition from other eyelid disorders such as entropion or ectropion, which involve different anatomical and clinical considerations.

When should H02.052 be used instead of related codes?

H02.052 should be used when the patient presents with misdirected eyelashes on the right lower eyelid without any signs of entropion. If entropion is present, H02.051 should be used instead.

What documentation supports H02.052?

Documentation should include a detailed ocular examination, noting the presence of misdirected eyelashes, associated symptoms, and any previous treatments attempted. Photographic evidence may also be beneficial.