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ICD-10 Guide
ICD-10 CodesH02.102

H02.102

Billable

Unspecified ectropion of right lower eyelid

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

Code Description

ICD-10 H02.102 is a billable code used to indicate a diagnosis of unspecified ectropion of right lower eyelid.

Key Diagnostic Point:

Ectropion of the eyelid is characterized by the outward turning of the eyelid margin, which can lead to exposure of the conjunctiva and cornea, resulting in irritation, dryness, and potential infection. The right lower eyelid specifically may be affected due to various factors including aging, trauma, or underlying conditions such as facial nerve palsy. Clinically, patients may present with symptoms such as tearing, redness, and discomfort. The anatomy involved includes the eyelid structures, including the orbicularis oculi muscle, tarsal plate, and the conjunctival surface. Disease progression can lead to chronic conjunctivitis or keratitis if left untreated. Diagnostic considerations involve a thorough ocular examination, assessment of eyelid position, and evaluation of associated symptoms. Imaging studies may be warranted in cases of suspected underlying orbital pathology. Management options range from conservative measures, such as lubricating eye drops, to surgical intervention for more severe cases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires a thorough understanding of eyelid anatomy and associated conditions.
  • Treatment complexity: Medium, with options ranging from conservative to surgical interventions.
  • Documentation requirements: Moderate, necessitating detailed clinical notes and symptom descriptions.
  • Coding specificity: Medium, as it is specific to ectropion of the right lower eyelid but may require differentiation from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misidentifying the eyelid affected or using a general ectropion code.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment history.
  • Billing challenges: Potential denials due to lack of supporting documentation for surgical procedures.

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

Plastic Surgery

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

Ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision problems. Its prevalence increases with age, making it a relevant concern in geriatric populations. Understanding the epidemiology of ectropion can help healthcare providers identify at-risk individuals and implement preventive measures. Quality measures may include tracking patient outcomes post-surgery and ensuring timely referrals to specialists for management.

ICD-9 vs ICD-10

Ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision problems. Its prevalence increases with age, making it a relevant concern in geriatric populations. Understanding the epidemiology of ectropion can help healthcare providers identify at-risk individuals and implement preventive measures. Quality measures may include tracking patient outcomes post-surgery and ensuring timely referrals to specialists for management.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for surgical procedures and ensuring that documentation supports the medical necessity of the treatment. Common denials may arise from insufficient documentation or failure to demonstrate the need for surgical intervention. Best practices include maintaining detailed clinical notes, ensuring accurate coding, and following payer-specific guidelines for billing procedures related to eyelid surgery.

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 H02.102?

H02.102 covers unspecified ectropion of the right lower eyelid, which may arise from various etiologies including age-related changes, trauma, or neurological conditions affecting eyelid function.

When should H02.102 be used instead of related codes?

H02.102 should be used when the ectropion is specifically localized to the right lower eyelid and no further specification is available. It is important to differentiate from other eyelid conditions such as entropion or other forms of ectropion.

What documentation supports H02.102?

Documentation should include a detailed ocular examination, patient-reported symptoms, treatment history, and any relevant imaging studies that support the diagnosis of ectropion.