H02.516 — Abnormal innervation syndrome left eye, unspecified eyelid
Is H02.516 billable?
Yes, but H02.516 is an unspecified code. H02.516 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, H02.516 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting H02.516 — the more specific alternatives are listed below.
H02.516 at a glance
| Code | H02.516 |
|---|---|
| Description | Abnormal innervation syndrome left eye, unspecified eyelid |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does H02.516 group to?
H02.516 sits in MDC 02 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 124Other Disorders of the Eye with MCC or Thrombolytic Agentmedical
- 125Other Disorders of the Eye without MCCmedical
How is H02.516 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to H02.516. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Syndrome › abnormal innervation › left
Excludes1 — never code together — inherited from H02
The conditions below can never be reported together with H02.516 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 H02.516, but a patient may have both at the same time. When documentation supports it, H02.516 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 H02.516, but a patient may have both at the same time. When documentation supports it, H02.516 and the excluded code may both be reported.
Excludes2 — not included here — inherited from H02.5
The conditions below are not part of H02.516, but a patient may have both at the same time. When documentation supports it, H02.516 and the excluded code may both be reported.
How long has H02.516 existed?
H02.516 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 H02.51 family? (6)
- H02.511Abnormal innervation syndrome right upper eyelid
- H02.512Abnormal innervation syndrome right lower eyelid
- H02.513Abnormal innervation syndrome right eye, unspecified eyelid
- H02.514Abnormal innervation syndrome left upper eyelid
- H02.515Abnormal innervation syndrome left lower eyelid
- H02.519Abnormal innervation syndrome unspecified eye, unspecified eyelid