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ICD-10 Guide
ICD-10 CodesH02.123

H02.123

Billable

Mechanical ectropion of right eye, unspecified eyelid

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

Code Description

ICD-10 H02.123 is a billable code used to indicate a diagnosis of mechanical ectropion of right eye, unspecified eyelid.

Key Diagnostic Point:

Mechanical ectropion of the right eye, unspecified eyelid, is characterized by the outward turning of the eyelid margin, which can lead to exposure of the conjunctiva and cornea. This condition often results from mechanical factors such as scarring, trauma, or excessive tension on the eyelid. The anatomy involved includes the eyelid structures, such as the orbicularis oculi muscle, tarsal plate, and skin, as well as the surrounding periocular tissues. Disease progression may lead to chronic irritation, tearing, and potential corneal damage due to exposure. Diagnostic considerations include a thorough clinical examination, assessment of eyelid function, and evaluation of any underlying conditions contributing to the ectropion. Treatment options may vary from conservative management, such as lubricating eye drops, to surgical intervention to restore normal eyelid position and function, depending on the severity and underlying cause of the ectropion.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of eyelid anatomy and potential underlying causes.
  • Treatment complexity: May involve both non-surgical and surgical options.
  • Documentation requirements: Detailed clinical notes are necessary to justify the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to differentiate from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misidentifying the side of the ectropion or confusing it with other eyelid conditions.
  • Documentation gaps: Incomplete clinical notes that do not support the diagnosis.
  • Billing challenges: Potential denials if the medical necessity for treatment is not clearly 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

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Mechanical ectropion can significantly affect a patient's quality of life, leading to discomfort, visual disturbances, and potential complications such as corneal ulcers. Understanding the epidemiology of ectropion, particularly in aging populations, can help healthcare providers anticipate and manage this condition effectively. Quality measures may include tracking patient outcomes post-treatment and ensuring timely interventions to prevent complications.

ICD-9 vs ICD-10

Mechanical ectropion can significantly affect a patient's quality of life, leading to discomfort, visual disturbances, and potential complications such as corneal ulcers. Understanding the epidemiology of ectropion, particularly in aging populations, can help healthcare providers anticipate and manage this condition effectively. Quality measures may include tracking patient outcomes post-treatment and ensuring timely interventions to prevent complications.

Reimbursement & Billing Impact

Reimbursement may depend on demonstrating the impact of the ectropion on the patient's quality of life and the potential for complications. Common denials may arise if the documentation does not clearly support the diagnosis or if the treatment plan is not adequately justified. Best practices include ensuring that all clinical notes are thorough and that any surgical procedures are well-documented with appropriate CPT codes.

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 H02.123?

H02.123 specifically covers mechanical ectropion of the right eye, which may arise from conditions such as scarring, trauma, or age-related changes affecting eyelid structure.

When should H02.123 be used instead of related codes?

H02.123 should be used when the ectropion is specifically mechanical in nature and affects the right eyelid, distinguishing it from other types of ectropion or eyelid disorders.

What documentation supports H02.123?

Documentation should include a detailed clinical examination, patient history, and any imaging or diagnostic tests that support the diagnosis of mechanical ectropion of the right eyelid.