Last-Minute Tips to Catch Every ICD-10-CM 2019 Eyelid Code Change

Fri, Sep 28, 2018 --

Coding Updates, ICD-10

ICD-10-CM 2019 adds specificity to eyelid diagnosis coding

It’s ICD-10-CM 2019-eve! A big chunk of the changes effective Oct. 1, 2018, make coding for many eyelid diagnoses more specific, requiring you to specify not only the eye but also the eyelid involved. To be sure you’re ready, here’s one last crash course in eyelid ICD-10-CM coding for 2019.

Which Diagnoses Have Upper/Lower Eyelid Requirements in 2019?

You’re going to need to know left eye or right eye, and upper eyelid or lower eyelid, for all of these eye care diagnoses in ICD-10-CM 2019.

Malignant Neoplasms

  • C43.1- (Malignant melanoma of eyelid, including canthus)
  • C4A.1- (Merkel cell carcinoma of eyelid, including canthus)
  • C44.1- (Other and unspecified malignant neoplasm of skin of eyelid, including canthus)
    • Tip: This subcategory includes unique codes for basal cell carcinoma, squamous cell carcinoma, sebaceous cell carcinoma, other specified, and unspecified.

In Situ Neoplasms

  • D03.1- (Melanoma in situ of eyelid, including canthus)
  • D04.1- (Carcinoma in situ of skin of eyelid, including canthus)

Benign Neoplasms

  • D22.1- (Melanocytic nevi of eyelid, including canthus)
  • D23.1- (Other benign neoplasm of skin of eyelid, including canthus)

Disorders of Eyelid, Lacrimal System, and Orbit

  • H01.0- (Blepharitis)
    • Tip: This subcategory includes unique codes for blepharitis documented as ulcerative and squamous, as well as unspecified blepharitis.
  • H02.15- (Paralytic ectropion of eyelid)
  • H02.2- (Lagophthalmos)
    • Tip: This subcategory includes unique codes for lagophthalmos documented as cicatricial, mechanical, and paralytic, as well as unspecified lagophthalmos.
  • H02.88- (Meibomian gland dysfunction of eyelid).

OK, But What Does a Reportable Code Look Like?

Note how this example of a complete reportable code includes the diagnosis, the eye involved (right or left), and the eyelid involved (upper or lower):

  • C43.111 (Malignant melanoma of right upper eyelid, including canthus).

Are There Any Codes That Have Upper and Lower Lids in the Same Code?

The majority of the codes are like our example code in the previous section, C43.111, with just a single lid listed. But there are new blepharitis codes in ICD-10-CM 2019 that let your report both upper and lower lids in a single code.

For instance, note the descriptor for H01.01B (Ulcerative blepharitis left eye, upper and lower eyelids).

There are existing codes to report blepharitis of a single lid, like H01.014 (Ulcerative blepharitis left upper eyelid), and you’ll still have those available in the 2019 code set.

What About You?

Do you find this level of specificity for eyelid ICD-10-CM codes helpful for your work so you can report multiple locations on the same claim? Or do you not find this change helpful from a coding perspective?


Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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