ICD-10 Coding for Stye Right Eye(H00.011, H00.012, H00.021, H00.023)
Complete ICD-10-CM coding and documentation guide for Stye Right Eye. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Stye Right Eye
H00.0-H00.1Primary Range
Hordeolum and Chalazion
This range includes codes for hordeolum (stye) and chalazion, which are common eyelid conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H00.011 | Hordeolum externum right upper eyelid | Use when documentation specifies an external stye on the right upper eyelid. |
|
| H00.012 | Hordeolum externum right lower eyelid | Use when documentation specifies an external stye on the right lower eyelid. |
|
| H00.021 | Hordeolum internum right upper eyelid | Use when documentation specifies an internal stye on the right upper eyelid. |
|
| H00.023 | Hordeolum internum unspecified right eyelid | Use when the specific eyelid location is not documented. |
|
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 right eye
Essential facts and insights about Stye Right Eye
Primary ICD-10-CM Codes for stye right eye
Decision Criteria
clinical Criteria
- Presence of a tender nodule at the eyelash base with visible pustule.
Applicable To
- External stye on right upper eyelid
Excludes
- Chalazion (H00.1x)
Clinical Validation Requirements
- Localized tenderness at eyelash base
- Visible pustule
Code-Specific Risks
- Confusion with chalazion if not properly documented
Coding Notes
- Ensure documentation specifies 'externum' and eyelid location.
H00.012 - Hordeolum externum right lower eyelid
Use when documentation specifies an external stye on the right lower eyelid.
Applicable To
- External stye on right lower eyelid
Excludes
- Chalazion (H00.1x)
Clinical Validation Requirements
- Tender nodule at base of right lower eyelashes
Coding Notes
Document the specific eyelid location and type of stye.
H00.021 - Hordeolum internum right upper eyelid
Use when documentation specifies an internal stye on the right upper eyelid.
Applicable To
- Internal stye on right upper eyelid
Excludes
- Chalazion (H00.1x)
Clinical Validation Requirements
- Swelling deep to tarsal plate
- Meibomian orifice blockage
Coding Notes
Ensure documentation specifies 'internum' and eyelid location.
H00.023 - Hordeolum internum unspecified right eyelid
Use when the specific eyelid location is not documented.
Applicable To
- Internal stye on unspecified right eyelid
Excludes
- Chalazion (H00.1x)
Clinical Validation Requirements
- General swelling and pain in the right eye
Coding Notes
Use only when documentation does not specify the eyelid.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Chalazion
H00.1XDocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Stye Right Eye to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H00.011.
Impact
Clinical: May lead to improper treatment if type is not clarified., Regulatory: Increases audit risk due to lack of specificity., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Train staff on documentation requirements, Use templates that prompt for specific details
Impact
Reimbursement: May lead to incorrect DRG assignment and affect reimbursement., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the eyelid location and use the appropriate specific code.
Impact
Frequent use of unspecified codes may trigger audits.
Mitigation Strategy
Ensure documentation specifies eyelid location and type.
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 Right Eye, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Stye Right Eye
Use these documentation templates to ensure complete and accurate documentation for Stye Right Eye. These templates include all required elements for proper coding and billing.
Primary Care Visit for Stye
Specialty: Primary CareRequired Elements
- Patient history
- Eyelid examination
- Diagnosis
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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