ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesH02.211

H02.211

Billable

Cicatricial lagophthalmos right upper eyelid

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

Code Description

ICD-10 H02.211 is a billable code used to indicate a diagnosis of cicatricial lagophthalmos right upper eyelid.

Key Diagnostic Point:

Cicatricial lagophthalmos of the right upper eyelid is characterized by an inability to fully close the eyelid due to scarring, which can result from various conditions such as trauma, surgery, or inflammatory diseases. The upper eyelid anatomy includes the skin, muscle (orbicularis oculi), and connective tissue, all of which play a role in eyelid function. In cicatricial lagophthalmos, the scarring may lead to exposure of the cornea, resulting in dryness, irritation, and potential damage to the ocular surface. Disease progression can lead to complications such as keratitis or corneal ulcers if left untreated. Diagnosis typically involves a thorough clinical examination, including assessment of eyelid closure and corneal health, often supplemented by imaging studies or slit-lamp examination. Treatment options may include surgical intervention to release the scar tissue, eyelid weights, or other supportive measures to protect the eye and restore function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a thorough understanding of eyelid anatomy and function.
  • Treatment complexity: May involve surgical and non-surgical interventions.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis.
  • Coding specificity: Requires precise coding to differentiate from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected eyelid.
  • Documentation gaps: Insufficient clinical details to support the diagnosis.
  • Billing challenges: Potential denials if documentation does not clearly outline the condition.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cicatricial lagophthalmos can significantly impact a patient's quality of life, leading to discomfort, visual impairment, and increased risk of ocular complications. Understanding the epidemiology of this condition is crucial, as it may arise from various underlying causes, including trauma and surgical interventions. Effective management can improve patient outcomes and reduce healthcare utilization by preventing complications associated with corneal exposure.

ICD-9 vs ICD-10

Cicatricial lagophthalmos can significantly impact a patient's quality of life, leading to discomfort, visual impairment, and increased risk of ocular complications. Understanding the epidemiology of this condition is crucial, as it may arise from various underlying causes, including trauma and surgical interventions. Effective management can improve patient outcomes and reduce healthcare utilization by preventing complications associated with corneal exposure.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of treatment, with surgical interventions often yielding higher reimbursement rates. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical details are included in the patient's record to support the diagnosis and treatment provided.

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 H02.211?

H02.211 specifically covers cicatricial lagophthalmos of the right upper eyelid, which can result from conditions such as burns, surgical scars, or chronic inflammatory diseases that lead to scarring and eyelid dysfunction.

When should H02.211 be used instead of related codes?

H02.211 should be used when the right upper eyelid is specifically affected by cicatricial lagophthalmos, differentiating it from other eyelid disorders such as ptosis or non-cicatricial lagophthalmos.

What documentation supports H02.211?

Documentation should include a detailed clinical history, examination findings demonstrating eyelid closure issues, and any imaging or diagnostic tests that support the diagnosis of cicatricial lagophthalmos.