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ICD-10 Guide
ICD-10 CodesH02.155

H02.155

Billable

Paralytic ectropion of left lower eyelid

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

Code Description

ICD-10 H02.155 is a billable code used to indicate a diagnosis of paralytic ectropion of left lower eyelid.

Key Diagnostic Point:

Paralytic ectropion of the left lower eyelid is characterized by the outward turning of the eyelid margin due to paralysis of the facial nerve, which innervates the muscles responsible for eyelid closure. This condition can lead to exposure keratitis, dry eye, and cosmetic concerns. The left lower eyelid's anatomy includes the orbicularis oculi muscle, which plays a crucial role in eyelid function. When this muscle is paralyzed, the eyelid cannot maintain proper contact with the eyeball, resulting in ectropion. Disease progression may vary; if left untreated, it can lead to chronic irritation and potential corneal damage. Diagnosis typically involves a thorough clinical examination, including assessment of eyelid position, corneal health, and evaluation of facial nerve function. Imaging studies may be warranted to rule out underlying structural issues. Treatment options may include surgical intervention to correct the eyelid position and restore function, as well as supportive measures to protect the eye from exposure.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of eyelid function and facial nerve integrity.
  • Treatment complexity: May involve surgical and non-surgical interventions.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary.
  • Coding specificity: Requires precise coding to differentiate from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of ectropion.
  • Documentation gaps: Incomplete records regarding facial nerve assessment.
  • Billing challenges: Potential denials if the medical necessity 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

Otolaryngology

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

Paralytic ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision impairment. Understanding the epidemiology of this condition is crucial, as it can arise from various causes, including neurological disorders and trauma. Effective management not only improves individual patient outcomes but also reduces healthcare utilization by preventing complications such as corneal ulcers. Quality measures should focus on timely diagnosis and appropriate intervention to enhance patient satisfaction and overall health.

ICD-9 vs ICD-10

Paralytic ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision impairment. Understanding the epidemiology of this condition is crucial, as it can arise from various causes, including neurological disorders and trauma. Effective management not only improves individual patient outcomes but also reduces healthcare utilization by preventing complications such as corneal ulcers. Quality measures should focus on timely diagnosis and appropriate intervention to enhance patient satisfaction and overall health.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the procedure performed, and it is essential to provide comprehensive clinical notes that justify the need for surgical intervention. Common denials may arise if the documentation does not adequately support the diagnosis or if the procedure is deemed not medically necessary. Coders should ensure that all relevant details, including the patient's history and treatment plan, are included to minimize audit risks.

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 H02.155?

H02.155 specifically covers paralytic ectropion of the left lower eyelid, primarily resulting from facial nerve paralysis, such as in Bell's palsy or after surgical trauma.

When should H02.155 be used instead of related codes?

H02.155 should be used when the ectropion is directly linked to paralysis of the facial nerve, distinguishing it from other forms of ectropion that may not involve nerve damage.

What documentation supports H02.155?

Documentation should include a detailed clinical assessment of eyelid position, facial nerve function tests, and any imaging studies performed to evaluate the underlying cause of paralysis.