ICD-10 Coding for Ectropion(H02.11, H02.12, H02.13)
Complete ICD-10-CM coding and documentation guide for Ectropion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ectropion
H02.1Primary Range
Ectropion
This range includes all types of ectropion, such as cicatricial, mechanical, and senile.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H02.11 | Cicatricial ectropion | Use when ectropion is due to scarring from burns, trauma, or surgery. |
|
| H02.12 | Mechanical ectropion | Use when ectropion is due to mechanical factors like tumors or prosthetics. |
|
| H02.13 | Senile ectropion | Use when ectropion is due to age-related changes. |
|
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 cicatricial ectropion
Essential facts and insights about Ectropion
Primary ICD-10-CM Codes for ectropion
Decision Criteria
clinical Criteria
- Presence of scar tissue causing ectropion.
Applicable To
- Scarring from burns
- Scarring from trauma
- Scarring from surgery
Excludes
- Entropion (H02.05-)
Clinical Validation Requirements
- Slit-lamp documentation of scar tissue
- Lid retraction
Code-Specific Risks
- Incorrectly using unspecified codes when specific laterality is documented.
Coding Notes
- Ensure documentation specifies the type and cause of ectropion.
H02.12 - Mechanical ectropion
Use when ectropion is due to mechanical factors like tumors or prosthetics.
Applicable To
- Mass effect from tumors
- Prosthetics causing displacement
Excludes
- Entropion (H02.05-)
Clinical Validation Requirements
- Imaging or operative report confirming mass effect
Coding Notes
Document the specific mechanical cause of ectropion.
H02.13 - Senile ectropion
Use when ectropion is due to age-related changes.
Applicable To
- Age-related laxity
Excludes
- Entropion (H02.05-)
Clinical Validation Requirements
- Lid distraction test >6 mm
Coding Notes
Ensure age-related changes are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Exposure keratitis
H16.2Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Entropion
H02.05Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ectropion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H02.11.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure thorough patient history and examination are documented.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreases accuracy of healthcare data.
Mitigation Strategy
Query provider for specific laterality and etiology.
Impact
Risk of audits due to use of unspecified codes.
Mitigation Strategy
Use specific codes with detailed 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 Ectropion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ectropion
Use these documentation templates to ensure complete and accurate documentation for Ectropion. These templates include all required elements for proper coding and billing.
Cicatricial ectropion due to burn scar
Specialty: OphthalmologyRequired Elements
- Patient history of facial burns
- Slit-lamp exam findings
- Lid retraction measurement
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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