ICD-10 Coding for Stye(H00.01, H00.02)
Complete ICD-10-CM coding and documentation guide for Stye. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Stye
H00.0-H00.1Primary Range
Hordeolum and chalazion
This range includes codes for both external and internal hordeolum, as well as chalazion, which are common eyelid conditions.
Bacterial and viral infectious agents
These codes are used to identify infectious agents, such as Staphylococcus aureus, when confirmed by culture.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H00.01 | External hordeolum | Use when documentation specifies 'external', 'sty', or 'glands of Zeis/Moll'. |
|
| H00.02 | Internal hordeolum | Use when documentation states 'internal' or 'meibomian gland involvement'. |
|
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 stye
Essential facts and insights about Stye
Primary ICD-10-CM Codes for stye
Decision Criteria
clinical Criteria
- Tender erythematous nodule at eyelid margin
documentation Criteria
- Documentation specifies 'external' or 'sty'
Applicable To
- Stye
- Hordeolum externum
Excludes
- Chalazion (H00.1)
Clinical Validation Requirements
- Presence of a tender, erythematous nodule at the eyelid margin
- Localized pustule at the base of an eyelash
Code-Specific Risks
- Incorrectly coding as unspecified when laterality is documented.
Coding Notes
- Ensure documentation specifies the type and location of the hordeolum.
H00.02 - Internal hordeolum
Use when documentation states 'internal' or 'meibomian gland involvement'.
Applicable To
- Hordeolum internum
Excludes
- Chalazion (H00.1)
Clinical Validation Requirements
- Deeper lid margin swelling without lash follicle involvement
- Meibomian gland involvement
Coding Notes
Ensure documentation specifies the type and location of the hordeolum.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Staphylococcus aureus as the cause of diseases classified elsewhere
B95.4Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Chalazion
H00.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Stye to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H00.01.
Impact
Clinical: May lead to incorrect treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denial due to lack of specificity.
Mitigation Strategy
Ensure all clinical notes specify whether the hordeolum is internal or external., Use templates to guide documentation.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases the accuracy of clinical data.
Mitigation Strategy
Always specify the eyelid location and laterality if documented.
Impact
Using unspecified codes when specific codes are applicable.
Mitigation Strategy
Implement documentation checks to ensure specificity.
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 Stye, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Stye
Use these documentation templates to ensure complete and accurate documentation for Stye. These templates include all required elements for proper coding and billing.
Acute external hordeolum
Specialty: OphthalmologyRequired Elements
- Laterality
- Eyelid location
- Type of hordeolum
- Presence of purulence
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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