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ICD-10 Guide
ICD-10 CodesH02.2

H02.2

Non-billable

Lagophthalmos

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

Code Description

ICD-10 H02.2 is a used to indicate a diagnosis of lagophthalmos.

Key Diagnostic Point:

Lagophthalmos is a condition characterized by the inability to close the eyelids completely, which can lead to exposure of the cornea and subsequent ocular complications. This disorder can arise from various etiologies, including facial nerve paralysis, trauma, or congenital anomalies. The eyelid anatomy plays a crucial role in protecting the eye; it consists of the upper and lower eyelids, which are controlled by the orbicularis oculi muscle. In lagophthalmos, the failure of these muscles to function properly results in inadequate eyelid closure. Clinically, patients may present with symptoms such as dryness, irritation, and redness of the eye, as well as potential corneal abrasions or ulcers due to exposure. Diagnosis typically involves a thorough clinical examination, including assessment of eyelid function and corneal health, and may utilize tests such as the Schirmer test to evaluate tear production. Treatment options vary based on the underlying cause and severity of the condition, ranging from lubricating eye drops to surgical interventions aimed at improving eyelid closure.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of underlying causes and associated conditions
  • Treatment complexity: May involve multiple treatment modalities depending on severity
  • Documentation requirements: Detailed documentation of symptoms and treatment response is necessary
  • Coding specificity: Requires precise coding to differentiate from other eyelid disorders

Audit Risk Factors

  • Common coding errors: Misclassification with other eyelid disorders
  • Documentation gaps: Incomplete records of patient history and treatment plans
  • Billing challenges: Potential denials if the medical necessity is not clearly established

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

Neurology

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

Lagophthalmos can significantly affect a patient's quality of life, leading to discomfort and potential vision loss if left untreated. It is crucial for healthcare providers to recognize this condition early to prevent complications. Understanding the epidemiology of lagophthalmos, particularly in populations with higher incidences of facial nerve disorders, can inform public health strategies and improve patient outcomes.

ICD-9 vs ICD-10

Lagophthalmos can significantly affect a patient's quality of life, leading to discomfort and potential vision loss if left untreated. It is crucial for healthcare providers to recognize this condition early to prevent complications. Understanding the epidemiology of lagophthalmos, particularly in populations with higher incidences of facial nerve disorders, can inform public health strategies and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement may depend on the thoroughness of the clinical notes, including the rationale for any surgical interventions or ongoing management. Common denials can occur if the documentation does not clearly establish the diagnosis or if the treatment plan lacks detail. Coders should ensure that all relevant CPT codes are used in conjunction with H02.2 to reflect the services provided accurately.

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 H02.2?

H02.2 specifically covers lagophthalmos, which may be associated with conditions such as Bell's palsy, stroke, or trauma leading to facial nerve dysfunction. It is essential to document the underlying cause for accurate coding.

When should H02.2 be used instead of related codes?

H02.2 should be used when the primary issue is the inability to close the eyelids completely, distinguishing it from ectropion or entropion, which involve eyelid positioning rather than closure.

What documentation supports H02.2?

Documentation should include a detailed history of the patient's symptoms, results from ocular examinations, and any relevant imaging or tests that support the diagnosis of lagophthalmos.