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ICD-10 Guide
ICD-10 CodesH02.135

H02.135

Billable

Senile ectropion of left lower eyelid

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

Code Description

ICD-10 H02.135 is a billable code used to indicate a diagnosis of senile ectropion of left lower eyelid.

Key Diagnostic Point:

Senile ectropion of the left lower eyelid is characterized by the outward turning of the eyelid margin, primarily affecting older adults. This condition results from age-related changes in the eyelid's connective tissue and muscle tone, leading to laxity and loss of elasticity. Clinically, patients may present with symptoms such as irritation, excessive tearing, and exposure keratitis due to the inability of the eyelid to adequately cover the eye. The anatomy involved includes the lower eyelid, orbicularis oculi muscle, and the surrounding periocular structures, which play a crucial role in eyelid function and tear drainage. Disease progression can lead to chronic irritation and potential complications such as conjunctivitis or corneal damage if left untreated. Diagnostic considerations include a thorough clinical examination, patient history, and possibly imaging studies to assess any underlying anatomical abnormalities. Treatment options may involve surgical intervention to correct the ectropion and restore proper eyelid function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires a clinical examination and understanding of eyelid anatomy.
  • Treatment complexity: Moderate, involving surgical options that necessitate careful planning and execution.
  • Documentation requirements: Moderate, requiring detailed clinical notes and justification for surgical intervention.
  • Coding specificity: High, as it specifically identifies the condition affecting the left lower eyelid.

Audit Risk Factors

  • Common coding errors: Misidentification of the eyelid affected or incorrect coding of the type of ectropion.
  • Documentation gaps: Incomplete clinical notes that do not fully describe the condition or treatment rationale.
  • Billing challenges: Potential denials if the surgical procedure is not adequately justified in the documentation.

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

Senile ectropion significantly impacts the quality of life for affected individuals, leading to discomfort and potential vision problems. Understanding the epidemiology of this condition is essential, as it primarily affects the aging population, contributing to increased healthcare utilization. Quality measures may include tracking surgical outcomes and patient satisfaction post-treatment, which can inform best practices in managing this common eyelid disorder.

ICD-9 vs ICD-10

Senile ectropion significantly impacts the quality of life for affected individuals, leading to discomfort and potential vision problems. Understanding the epidemiology of this condition is essential, as it primarily affects the aging population, contributing to increased healthcare utilization. Quality measures may include tracking surgical outcomes and patient satisfaction post-treatment, which can inform best practices in managing this common eyelid disorder.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the medical necessity of the procedure, ensuring that the documentation aligns with the CPT codes used, and addressing any common denials related to lack of supporting evidence. Coders should ensure that all relevant details, such as the patient's symptoms and treatment rationale, are clearly documented to facilitate the billing process and reduce the risk of audits.

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 H02.135?

H02.135 specifically covers senile ectropion of the left lower eyelid, which is characterized by the outward turning of the eyelid margin due to age-related changes. It may also encompass associated symptoms such as irritation and tearing.

When should H02.135 be used instead of related codes?

H02.135 should be used when the condition specifically affects the left lower eyelid. If the right eyelid is affected, H02.134 should be used. Accurate documentation of the affected eyelid is crucial for correct code selection.

What documentation supports H02.135?

Documentation should include a detailed clinical examination, patient history, and any relevant imaging studies. Notes should clearly describe the symptoms, the impact on the patient’s quality of life, and the rationale for any surgical intervention.