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ICD-10 Guide
ICD-10 CodesH02.223

H02.223

Billable

Mechanical lagophthalmos right eye, unspecified eyelid

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

Code Description

ICD-10 H02.223 is a billable code used to indicate a diagnosis of mechanical lagophthalmos right eye, unspecified eyelid.

Key Diagnostic Point:

Mechanical lagophthalmos of the right eye, specifically affecting the unspecified eyelid, is a condition characterized by the inability to completely close the eyelids. This can result from various etiologies, including neurological disorders, trauma, or mechanical obstruction. The eyelid anatomy, comprising the upper and lower eyelids, plays a crucial role in protecting the ocular surface and maintaining tear film stability. In cases of lagophthalmos, the exposed cornea may lead to dryness, irritation, or even corneal ulceration due to inadequate lubrication. Disease progression can vary; if left untreated, patients may experience significant discomfort and visual impairment. Diagnostic considerations include a thorough clinical examination, assessment of eyelid function, and possibly imaging studies to evaluate underlying causes. Treatment options may involve surgical interventions, such as eyelid tightening procedures, or non-surgical methods like the use of moisture goggles or lubricating eye drops to manage symptoms effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of eyelid anatomy and function.
  • Treatment complexity: May involve surgical and non-surgical management.
  • Documentation requirements: Detailed documentation of symptoms and treatment plans is essential.
  • Coding specificity: Requires precise coding to differentiate from other eyelid disorders.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected eyelid.
  • Documentation gaps: Incomplete records of patient history and treatment.
  • Billing challenges: Potential denials due to lack of specificity in documentation.

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

The clinical significance of H02.223 lies in its potential to cause discomfort and visual impairment due to exposure of the cornea. Population health impact includes the need for timely diagnosis and management to prevent complications such as corneal ulcers. Quality measures may focus on patient-reported outcomes related to eye health and the effectiveness of interventions. Understanding healthcare utilization patterns for this condition can aid in resource allocation and improve patient care strategies.

ICD-9 vs ICD-10

The clinical significance of H02.223 lies in its potential to cause discomfort and visual impairment due to exposure of the cornea. Population health impact includes the need for timely diagnosis and management to prevent complications such as corneal ulcers. Quality measures may focus on patient-reported outcomes related to eye health and the effectiveness of interventions. Understanding healthcare utilization patterns for this condition can aid in resource allocation and improve patient care strategies.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for treatment is clearly documented, particularly if surgical intervention is required. Common denials may arise from insufficient documentation or failure to demonstrate the impact of the condition on the patient's quality of life. Best practices include maintaining comprehensive records of patient assessments, treatment plans, and follow-up care to substantiate 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 H02.223?

H02.223 covers mechanical lagophthalmos specifically affecting the right eye. This condition may arise from various causes, including facial nerve palsy, trauma, or congenital abnormalities that prevent the eyelids from closing fully.

When should H02.223 be used instead of related codes?

H02.223 should be used when the mechanical lagophthalmos is confirmed to affect the right eye. It is important to differentiate it from other codes that may pertain to the left eye or other types of eyelid dysfunction.

What documentation supports H02.223?

Documentation should include a detailed clinical history, examination findings indicating eyelid function, and any imaging studies that support the diagnosis of mechanical lagophthalmos affecting the right eye.