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ICD-10 Guide
ICD-10 CodesH02.139

H02.139

Billable

Senile ectropion of unspecified eye, unspecified eyelid

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

Code Description

ICD-10 H02.139 is a billable code used to indicate a diagnosis of senile ectropion of unspecified eye, unspecified eyelid.

Key Diagnostic Point:

Senile ectropion of the unspecified eye and eyelid is a condition characterized by the outward turning of the eyelid margin, commonly associated with aging. This condition can lead to exposure of the conjunctiva and cornea, resulting in irritation, dryness, and potential complications such as conjunctivitis or corneal ulcers. The anatomy involved includes the eyelid structures, such as the orbicularis oculi muscle, tarsal plate, and the conjunctival lining. Disease progression typically involves gradual weakening of the eyelid support structures due to age-related changes, leading to laxity and ectropion. Diagnostic considerations include a thorough clinical examination, patient history, and assessment of symptoms such as tearing, irritation, or visual disturbances. It is essential to differentiate senile ectropion from other forms, such as cicatricial ectropion, which may arise from scarring or trauma. Treatment options may include surgical intervention, such as eyelid tightening procedures, to restore normal eyelid position and function.

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 potential surgical interventions needed.
  • Documentation requirements: Requires detailed clinical notes and symptom descriptions.
  • Coding specificity: Specific to senile ectropion, but may require additional codes for associated conditions.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of ectropion.
  • Documentation gaps: Incomplete patient history or lack of symptom description.
  • Billing challenges: Potential denials if the medical necessity for treatment is not well 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

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Senile ectropion can significantly impact the quality of life for affected individuals, leading to discomfort and potential vision problems. Understanding the epidemiology of this condition is crucial, as it primarily affects the aging population. Effective management can reduce healthcare utilization by preventing complications such as infections or corneal damage, thus improving overall population health outcomes.

ICD-9 vs ICD-10

Senile ectropion can significantly impact the quality of life for affected individuals, leading to discomfort and potential vision problems. Understanding the epidemiology of this condition is crucial, as it primarily affects the aging population. Effective management can reduce healthcare utilization by preventing complications such as infections or corneal damage, thus improving overall population health outcomes.

Reimbursement & Billing Impact

reimbursement.

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 H02.139?

H02.139 covers senile ectropion of the unspecified eye and eyelid, which is primarily associated with aging. It does not include ectropion due to scarring or other causes, which would require different coding.

When should H02.139 be used instead of related codes?

H02.139 should be used when the ectropion is specifically due to senile changes and is not localized to a specific eyelid or eye. If the condition is more specific, such as affecting the right upper eyelid, the corresponding specific code should be used.

What documentation supports H02.139?

Documentation should include a comprehensive eye examination report, patient history indicating age-related changes, and descriptions of symptoms such as irritation or tearing. Any treatment plans or surgical interventions should also be documented.