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Home/Diagnosis/ICD-10 Coding for Droopy Eyelid

ICD-10 Coding for Droopy Eyelid

H02.401
H02.402
H02.403

Complete ICD-10-CM coding and documentation guide for icd-10 coding for droopy eyelid includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Ptosis
Eyelid Droop
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Key Information: ICD-10 Coding for Droopy Eyelid

Essential facts and insights about ICD-10 Coding for Droopy Eyelid

Use ICD-10 code H02.401 for ptosis of right eyelid, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Ptosis of right eyelid

Billable Code
H02.401
Billable

Diagnostic Criteria

  • • MRD-1 of ≤2.5mm
  • • Levator function ≤10mm

Applicable To

  • • Right eyelid droop

Important Notes

  • • Ensure laterality is documented to avoid unspecified coding.

Ptosis of left eyelid

Billable Code
H02.402
Billable

Diagnostic Criteria

  • • MRD-1 of ≤2.5mm
  • • Levator function ≤10mm

Applicable To

  • • Left eyelid droop

Important Notes

  • • Ensure laterality is documented to avoid unspecified coding.

Ptosis of bilateral eyelids

Billable Code
H02.403
Billable

Diagnostic Criteria

  • • MRD-1 of ≤2.5mm
  • • Levator function ≤10mm

Applicable To

  • • Bilateral eyelid droop

Important Notes

  • • Ensure laterality is documented to avoid unspecified coding.

Ptosis of unspecified eyelid

Billable Code
H02.409
Billable

Diagnostic Criteria

  • • MRD-1 of ≤2.5mm
  • • Levator function ≤10mm

Applicable To

  • • Unspecified eyelid droop

Important Notes

  • • Avoid using unspecified codes when laterality is known.
Ancillary Codes

Additional codes that may be used with this diagnosis

H53.46

Peripheral vision loss

Use when ptosis causes documented peripheral vision loss.

Frequently Asked Questions

What is the ICD-10 code for droopy eyelid?

The ICD-10 code for droopy eyelid, or ptosis, is H02.4-, with specific codes for right (H02.401), left (H02.402), and bilateral (H02.403) eyelids.

How is ptosis documented for insurance coverage?

Ptosis documentation should include MRD-1 measurements, visual field test results, and photographic evidence to demonstrate functional impairment.

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