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Home/Diagnosis/ICD-10 Coding for Eyelid Droop

ICD-10 Coding for Eyelid Droop

H02.40
H02.41
H02.42

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

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

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

Use ICD-10 code H02.40 for unspecified ptosis of eyelid, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Unspecified ptosis of eyelid

Non-Billable
H02.40
Non-Billable

Diagnostic Criteria

clinical:
  • • Ptosis present but etiology unclear

Applicable To

  • • Unspecified type of ptosis

Important Notes

  • • Ensure documentation supports the unspecified nature of the ptosis.

Mechanical ptosis of eyelid

Non-Billable
H02.41
Non-Billable

Diagnostic Criteria

clinical:
  • • Presence of eyelid mass or scarring

Applicable To

  • • Ptosis due to eyelid tumors or cysts

Important Notes

  • • Document the mechanical cause clearly.

Myogenic ptosis of eyelid

Non-Billable
H02.42
Non-Billable

Diagnostic Criteria

clinical:
  • • Levator function test showing weakness

Applicable To

  • • Ptosis due to muscle weakness

Important Notes

  • • Document muscle weakness and related tests.

Paralytic ptosis of eyelid

Non-Billable
H02.43
Non-Billable

Diagnostic Criteria

clinical:
  • • Documented nerve paralysis

Applicable To

  • • Ptosis due to nerve paralysis

Important Notes

  • • Document the specific nerve involved.

Other specified disorders of eyelid

Billable Code
H02.89
Billable

Diagnostic Criteria

clinical:
  • • Excess skin without true ptosis

Applicable To

  • • Dermatochalasis
  • • Floppy eyelid syndrome

Important Notes

  • • Ensure documentation differentiates from true ptosis.

Congenital ptosis

Billable Code
Q10.0
Billable

Diagnostic Criteria

clinical:
  • • Present at birth with poor levator function

Applicable To

  • • Ptosis present at birth

Important Notes

  • • Document congenital onset and associated findings.
Frequently Asked Questions

What is the ICD-10 code for eyelid droop?

The ICD-10 code for eyelid droop, or ptosis, is primarily H02.4, with specific subcodes for different types such as mechanical (H02.41), myogenic (H02.42), and paralytic (H02.43).

How do you document eyelid droop for insurance?

Document eyelid droop by including MRD1 measurements, visual field testing results, and the functional impact on daily activities to establish medical necessity.

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