ICD-10 Coding for Brow Ptosis(H57.811, H57.812, H57.813, H57.819)
Complete ICD-10-CM coding and documentation guide for Brow Ptosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Brow Ptosis
H57.81-H57.819Primary Range
Brow ptosis codes specifying laterality
These codes are specific to brow ptosis and include laterality, which is essential for accurate documentation and billing.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H57.811 | Brow ptosis, right eye | Use when brow ptosis affects the right eye and causes functional impairment. |
|
| H57.812 | Brow ptosis, left eye | Use when brow ptosis affects the left eye and causes functional impairment. |
|
| H57.813 | Brow ptosis, bilateral | Use when brow ptosis affects both eyes and causes functional impairment. |
|
| H57.819 | Brow ptosis, unspecified eye | Use when brow ptosis affects an unspecified eye and causes functional impairment. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for brow ptosis
Essential facts and insights about Brow Ptosis
Primary ICD-10-CM Codes for brow ptosis
Decision Criteria
clinical Criteria
- Brow position and visual field improvement with elevation
Applicable To
- Right brow droop
Excludes
- Eyelid ptosis (H02.4-)
Clinical Validation Requirements
- Brow position ≤1 cm above superior orbital rim
- Visual field loss ≥12° improvement with brow elevation
Code-Specific Risks
- Incorrectly coding as eyelid ptosis
Coding Notes
- Ensure documentation supports functional impairment due to brow ptosis.
H57.812 - Brow ptosis, left eye
Use when brow ptosis affects the left eye and causes functional impairment.
Applicable To
- Left brow droop
Excludes
- Eyelid ptosis (H02.4-)
Clinical Validation Requirements
- Brow position ≤1 cm above superior orbital rim
- Visual field loss ≥12° improvement with brow elevation
Coding Notes
Ensure documentation supports functional impairment due to brow ptosis.
H57.813 - Brow ptosis, bilateral
Use when brow ptosis affects both eyes and causes functional impairment.
Applicable To
- Bilateral brow droop
Excludes
- Eyelid ptosis (H02.4-)
Clinical Validation Requirements
- Brow position ≤1 cm above superior orbital rim
- Visual field loss ≥12° improvement with brow elevation
Coding Notes
Ensure documentation supports functional impairment due to brow ptosis.
H57.819 - Brow ptosis, unspecified eye
Use when brow ptosis affects an unspecified eye and causes functional impairment.
Applicable To
- Unspecified brow droop
Excludes
- Eyelid ptosis (H02.4-)
Clinical Validation Requirements
- Brow position ≤1 cm above superior orbital rim
- Visual field loss ≥12° improvement with brow elevation
Coding Notes
Ensure documentation supports functional impairment due to brow ptosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Brow Ptosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H57.811.
Impact
Clinical: May lead to unnecessary procedures, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Ensure visual field tests are part of the pre-surgical assessment, Include test results in the patient's record
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Using incorrect codes can result in compliance issues., Data Quality: Misclassification affects data accuracy and quality.
Mitigation Strategy
Ensure the documentation specifies brow ptosis and use H57.81- codes.
Impact
Reimbursement: Incorrect CPT code may lead to non-payment., Compliance: Improper coding can result in audits and penalties., Data Quality: Affects the accuracy of procedural data.
Mitigation Strategy
Use 67900 only for functional repairs with documented medical necessity.
Impact
Using eyelid ptosis codes instead of brow ptosis codes.
Mitigation Strategy
Educate coders on the distinction between brow and eyelid ptosis.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Brow Ptosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Brow Ptosis
Use these documentation templates to ensure complete and accurate documentation for Brow Ptosis. These templates include all required elements for proper coding and billing.
Brow ptosis affecting vision
Specialty: OphthalmologyRequired Elements
- Visual complaint
- Brow position measurement
- Visual field test results
- Photographic evidence
- Medical necessity statement
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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