ICD-10 Coding for Chalazion(H00.14, H00.15)
Complete ICD-10-CM coding and documentation guide for Chalazion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chalazion
H00.1Primary Range
Chalazion
This range includes codes for chalazion based on the specific eyelid affected.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H00.14 | Chalazion left upper eyelid | Use when the chalazion is located on the left upper eyelid. |
|
| H00.15 | Chalazion left lower eyelid | Use when the chalazion is located on the left lower eyelid. |
|
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 chalazion
Essential facts and insights about Chalazion
Primary ICD-10-CM Codes for chalazion
Decision Criteria
clinical Criteria
- Presence of a non-tender nodule on the left upper eyelid.
documentation Criteria
- Documented failure of conservative treatment.
Applicable To
- Chalazion of the left upper eyelid
Excludes
- Infected meibomian gland (H00.02)
Clinical Validation Requirements
- Exact location on the left upper eyelid
- Duration of the chalazion
- Conservative treatment attempts
Code-Specific Risks
- Incorrect laterality documentation
- Missing documentation of conservative treatment
Coding Notes
- Ensure documentation specifies the exact eyelid and any conservative treatments attempted.
H00.15 - Chalazion left lower eyelid
Use when the chalazion is located on the left lower eyelid.
Applicable To
- Chalazion of the left lower eyelid
Excludes
- Infected meibomian gland (H00.02)
Clinical Validation Requirements
- Exact location on the left lower eyelid
- Duration of the chalazion
- Conservative treatment attempts
Coding Notes
Ensure documentation specifies the exact eyelid and any conservative treatments attempted.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Infected meibomian gland
H00.02Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chalazion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H00.14.
Impact
Clinical: May lead to unnecessary procedures., Regulatory: Non-compliance with pre-authorization requirements., Financial: Denial of claims for surgical procedures.
Mitigation Strategy
Document all conservative treatments tried, Include duration and frequency of treatments
Impact
Reimbursement: Claims may be denied if laterality is incorrect., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure documentation specifies the exact eyelid affected.
Impact
Failure to document laterality can lead to coding errors.
Mitigation Strategy
Implement double-check systems for laterality documentation.
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 Chalazion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chalazion
Use these documentation templates to ensure complete and accurate documentation for Chalazion. These templates include all required elements for proper coding and billing.
Ophthalmology Progress Note
Specialty: OphthalmologyRequired Elements
- Location of chalazion
- Duration
- Conservative treatments tried
- Functional impact
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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