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ICD-10 Guide
ICD-10 CodesH02.133

H02.133

Billable

Senile ectropion of right eye, unspecified eyelid

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

Code Description

ICD-10 H02.133 is a billable code used to indicate a diagnosis of senile ectropion of right eye, unspecified eyelid.

Key Diagnostic Point:

Senile ectropion of the right eye, unspecified eyelid, is characterized by the outward turning of the eyelid margin, commonly affecting the lower eyelid. This condition is often seen in elderly patients due to age-related changes in the skin and muscle tone around the eyes. Clinically, patients may present with symptoms such as ocular irritation, excessive tearing, and exposure keratitis due to the inability of the eyelid to adequately cover the eye. The anatomy involved includes the eyelid structures, such as the orbicularis oculi muscle, tarsal plate, and conjunctiva, which can be affected by laxity and loss of elasticity. Disease progression can lead to chronic irritation and potential complications like corneal ulcers if left untreated. Diagnostic considerations include a thorough ocular examination, assessment of eyelid position, and evaluation of associated symptoms. Treatment options may range from conservative management, such as lubricating eye drops, to surgical intervention for severe cases. Accurate diagnosis and coding are essential for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires clinical evaluation and differentiation from other eyelid disorders.
  • Treatment complexity: Moderate, with options ranging from conservative to surgical interventions.
  • Documentation requirements: Requires detailed clinical notes to support the diagnosis.
  • Coding specificity: Specific to senile ectropion of the right eye, but may require additional codes for associated conditions.

Audit Risk Factors

  • Common coding errors: Misidentifying the eye affected or not specifying the eyelid.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment.
  • Billing challenges: Potential denials if the 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

Geriatrics

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

Senile ectropion can significantly affect the quality of life in elderly patients, leading to discomfort and potential complications such as corneal damage. Understanding the epidemiology of this condition is crucial, as it is prevalent in the aging population. Effective management can improve patient outcomes and reduce healthcare utilization by preventing complications associated with untreated ectropion.

ICD-9 vs ICD-10

Senile ectropion can significantly affect the quality of life in elderly patients, leading to discomfort and potential complications such as corneal damage. Understanding the epidemiology of this condition is crucial, as it is prevalent in the aging population. Effective management can improve patient outcomes and reduce healthcare utilization by preventing complications associated with untreated ectropion.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of the procedure if surgical intervention is performed. Common denials may arise from insufficient documentation or lack of clarity regarding the specific eyelid affected. Coders should ensure that all relevant clinical details are included in the medical record to support the billing process. Best practices include using modifiers when necessary and ensuring that the procedure codes align with the diagnosis.

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 H02.133?

H02.133 specifically covers senile ectropion of the right eye, which is an age-related condition characterized by the outward turning of the eyelid margin, primarily affecting the lower eyelid.

When should H02.133 be used instead of related codes?

H02.133 should be used when the condition is specifically identified as senile ectropion of the right eye. It is important to differentiate it from other eyelid disorders such as entropion or ectropion of the left eye.

What documentation supports H02.133?

Documentation should include a detailed clinical examination, patient symptoms (such as tearing or irritation), and any treatment provided. Photographic evidence may also support the diagnosis.