ICD-10 Coding for Xanthelasma(H02.61, H02.64)
Complete ICD-10-CM coding and documentation guide for Xanthelasma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Xanthelasma
H02.6Primary Range
Xanthelasma of eyelid
This range includes all codes related to xanthelasma affecting the eyelids, specifying laterality and location.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H02.61 | Xanthelasma of right upper eyelid | Use when xanthelasma is present on the right upper eyelid. |
|
| H02.64 | Xanthelasma of left upper eyelid | Use when xanthelasma is present on the left upper eyelid. |
|
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 xanthelasma
Essential facts and insights about Xanthelasma
Primary ICD-10-CM Codes for xanthelasma
Decision Criteria
clinical Criteria
- Presence of yellow plaque on right upper eyelid
Applicable To
- Right upper eyelid xanthelasma
Excludes
- Other eyelid conditions not specified as xanthelasma
Clinical Validation Requirements
- Clinical diagnosis of xanthelasma
- Documentation of yellow plaque on right upper eyelid
Code-Specific Risks
- Incorrect laterality documentation
Coding Notes
- Ensure laterality is correctly documented to avoid coding errors.
H02.64 - Xanthelasma of left upper eyelid
Use when xanthelasma is present on the left upper eyelid.
Applicable To
- Left upper eyelid xanthelasma
Excludes
- Other eyelid conditions not specified as xanthelasma
Clinical Validation Requirements
- Clinical diagnosis of xanthelasma
- Documentation of yellow plaque on left upper eyelid
Coding Notes
Ensure laterality is correctly documented to avoid coding errors.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pure hypercholesterolemia
E78.0Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Xanthelasma of right lower eyelid
H02.62Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Xanthelasma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H02.61.
Impact
Clinical: Incomplete patient profile, Regulatory: Potential non-compliance with coding standards, Financial: Missed opportunities for appropriate reimbursement
Mitigation Strategy
Review patient's medical history for lipid disorders, Include lab results in documentation
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Always specify laterality when documented in the medical record.
Impact
Using unspecified codes when laterality is documented.
Mitigation Strategy
Ensure documentation includes specific laterality and use corresponding codes.
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 Xanthelasma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Xanthelasma
Use these documentation templates to ensure complete and accurate documentation for Xanthelasma. These templates include all required elements for proper coding and billing.
Ophthalmology examination for xanthelasma
Specialty: OphthalmologyRequired Elements
- Location and size of lesion
- Laterality
- Associated conditions like hyperlipidemia
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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