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ICD-10 Guide
ICD-10 CodesH02.054

H02.054

Billable

Trichiasis without entropion left upper eyelid

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

Code Description

ICD-10 H02.054 is a billable code used to indicate a diagnosis of trichiasis without entropion left upper eyelid.

Key Diagnostic Point:

Trichiasis is a condition characterized by the misdirection of eyelashes, leading to irritation of the cornea and conjunctiva. In the case of H02.054, the condition specifically affects the left upper eyelid. The eyelashes grow inward towards the eye, which can cause discomfort, redness, tearing, and potential damage to the ocular surface. The anatomy involved includes the eyelid, eyelashes, conjunctiva, and cornea. Trichiasis can occur due to various factors, including previous trauma, inflammation, or surgical procedures affecting the eyelid. Disease progression may lead to chronic irritation, corneal abrasions, or even vision impairment if left untreated. Diagnosis typically involves a thorough ocular examination, where the clinician assesses the eyelid position and the direction of the eyelashes. Treatment options may include epilation (removal of the misdirected eyelashes), cryotherapy, or surgical intervention to correct the eyelid position. Proper diagnosis and management are crucial to prevent complications and preserve ocular health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a detailed ocular examination and understanding of eyelid anatomy.
  • Treatment complexity: May involve multiple treatment modalities depending on severity.
  • Documentation requirements: Requires precise documentation of symptoms and treatment plans.
  • Coding specificity: Specific to trichiasis without entropion, necessitating accurate coding.

Audit Risk Factors

  • Common coding errors: Misidentifying trichiasis as entropion.
  • Documentation gaps: Incomplete records of patient symptoms or treatment history.
  • 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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Trichiasis can significantly affect a patient's quality of life due to discomfort and potential vision impairment. Understanding the epidemiology of this condition is vital, as it may be more prevalent in certain populations due to underlying conditions or previous ocular surgeries. Effective management of trichiasis can lead to improved patient outcomes, reduced healthcare utilization, and enhanced quality measures in ophthalmic care.

ICD-9 vs ICD-10

Trichiasis can significantly affect a patient's quality of life due to discomfort and potential vision impairment. Understanding the epidemiology of this condition is vital, as it may be more prevalent in certain populations due to underlying conditions or previous ocular surgeries. Effective management of trichiasis can lead to improved patient outcomes, reduced healthcare utilization, and enhanced quality measures in ophthalmic care.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the treatment provided, and it is crucial to follow payer-specific guidelines. Common denials may arise from insufficient documentation or incorrect coding. Best practices include thorough documentation of the patient's symptoms, treatment rationale, and any follow-up care provided. Coders should also ensure that the correct CPT codes are used in conjunction with H02.054 to reflect the services rendered accurately.

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 H02.054?

H02.054 specifically covers trichiasis affecting the left upper eyelid without the presence of entropion. It is important to differentiate this condition from other eyelid disorders such as entropion or ectropion.

When should H02.054 be used instead of related codes?

H02.054 should be used when the patient presents with inward-growing eyelashes on the left upper eyelid without any associated eyelid deformities like entropion. Accurate assessment and documentation are essential for code selection.

What documentation supports H02.054?

Documentation should include a detailed ocular examination report, patient history of symptoms, treatment provided, and any previous interventions related to the eyelid. Photographic evidence may also support the diagnosis.