H02.4 — Ptosis of eyelid
Is H02.4 billable?
No — H02.4 is a non-billable header code. H02.4 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 16 billable codes beneath H02.4.
Billable codes under this header
- H02.401Unspecified ptosis of right eyelid
- H02.402Unspecified ptosis of left eyelid
- H02.403Unspecified ptosis of bilateral eyelids
- H02.409Unspecified ptosis of unspecified eyelid
- H02.411Mechanical ptosis of right eyelid
- H02.412Mechanical ptosis of left eyelid
- H02.413Mechanical ptosis of bilateral eyelids
- H02.419Mechanical ptosis of unspecified eyelid
- H02.421Myogenic ptosis of right eyelid
- H02.422Myogenic ptosis of left eyelid
- H02.423Myogenic ptosis of bilateral eyelids
- H02.429Myogenic ptosis of unspecified eyelid
- H02.431Paralytic ptosis of right eyelid
- H02.432Paralytic ptosis of left eyelid
- H02.433Paralytic ptosis of bilateral eyelids
- H02.439Paralytic ptosis unspecified eyelid
H02.4 at a glance
| Code | H02.4 |
|---|---|
| Description | Ptosis of eyelid |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes1 — never code together — inherited from H02
The conditions below can never be reported together with H02.4 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- congenital malformations of eyelid (Q10.0-Q10.3)
Excludes2 — not included here — inherited from Chapter 7
The conditions below are not part of H02.4, but a patient may have both at the same time. When documentation supports it, H02.4 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury (trauma) of eye and orbit (S05.-)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)
Excludes2 — not included here — inherited from H00-H05
The conditions below are not part of H02.4, but a patient may have both at the same time. When documentation supports it, H02.4 and the excluded code may both be reported.
What codes fall under H02.4? (4)
How long has H02.4 existed?
H02.4 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the H02 family? (9)
- H02.0Entropion and trichiasis of eyelidnot billable
- H02.1Ectropion of eyelidnot billable
- H02.2Lagophthalmosnot billable
- H02.3Blepharochalasisnot billable
- H02.5Other disorders affecting eyelid functionnot billable
- H02.6Xanthelasma of eyelidnot billable
- H02.7Other and unspecified degenerative disorders of eyelid and periocular areanot billable
- H02.8Other specified disorders of eyelidnot billable
- H02.9Unspecified disorder of eyelid