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ICD-10 Guide
ICD-10 CodesH02.20

H02.20

Non-billable

Unspecified lagophthalmos

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

Code Description

ICD-10 H02.20 is a used to indicate a diagnosis of unspecified lagophthalmos.

Key Diagnostic Point:

Unspecified lagophthalmos refers to the inability to completely close the eyelids, which can lead to exposure of the cornea and conjunctiva. This condition may arise from various etiologies, including facial nerve paralysis, trauma, or congenital malformations. The eyelids play a crucial role in protecting the ocular surface, maintaining moisture, and facilitating tear distribution. In cases of lagophthalmos, the affected individual may experience symptoms such as dryness, irritation, and increased risk of corneal abrasions or infections. The progression of lagophthalmos can lead to more severe ocular complications if left untreated. Diagnosis typically involves a thorough clinical examination, including assessment of eyelid function and corneal health. Additional diagnostic tools may include slit-lamp examination and tear break-up time tests to evaluate the integrity of the tear film. Understanding the underlying cause is essential for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassification of the cause of lagophthalmos.
  • Documentation gaps may occur if the underlying cause is not clearly stated.
  • Billing challenges can arise from the need for detailed treatment plans and follow-up care.

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. Understanding its prevalence and impact on population health is crucial for healthcare providers. Effective management can reduce healthcare utilization by preventing complications such as corneal ulcers and infections. Awareness of this condition can improve quality measures related to eye care and enhance patient outcomes.

ICD-9 vs ICD-10

Lagophthalmos can significantly affect a patient's quality of life, leading to discomfort and potential vision loss. Understanding its prevalence and impact on population health is crucial for healthcare providers. Effective management can reduce healthcare utilization by preventing complications such as corneal ulcers and infections. Awareness of this condition can improve quality measures related to eye care and enhance patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear linkage between the diagnosis and the services rendered. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining thorough records of patient interactions, treatment plans, and follow-up care to support claims.

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 H02.20?

H02.20 covers unspecified lagophthalmos, which may result from various conditions such as Bell's palsy, trauma, or congenital issues affecting eyelid closure. It does not specify the underlying cause, allowing for broader application in clinical settings.

When should H02.20 be used instead of related codes?

H02.20 should be used when the specific cause of lagophthalmos is unknown or not documented. If the lagophthalmos is due to a known condition, such as facial nerve paralysis, the more specific code (e.g., H02.21) should be utilized.

What documentation supports H02.20?

Documentation should include a detailed clinical history, examination findings, and any diagnostic tests performed. It is essential to note the symptoms experienced by the patient and any treatments attempted to support the use of this code.