H02.401
H02.401 — Unspecified ptosis of right eyelid
Billable / specific codeICD-10-CMright
H02.401 is a billable, specific ICD-10-CM code for unspecified ptosis of right eyelid. It is valid for submission on a claim.
Risk adjustment
H02.401 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
H02.401 is named in 15 Medicare coverage policies — 15 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
- A54969Billing and Coding: Nerve Conduction Studies and Electromyography
- A56439Billing and Coding: Blepharoplasty
- A56503Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift
Related codes at this level
Codes that share H02.40. If H02.401 is not quite right, the correct code is usually one of these.
Questions about H02.401
- Is H02.401 a billable ICD-10-CM code?
- Yes. H02.401 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H02.401 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of eyelid, lacrimal system and orbit (H00-H05).