H02.413
H02.413 — Mechanical ptosis of bilateral eyelids
Billable / specific codeICD-10-CMbilateral
H02.413 is a billable, specific ICD-10-CM code for mechanical ptosis of bilateral eyelids. It is valid for submission on a claim.
Risk adjustment
H02.413 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
H02.413 is named in 10 Medicare coverage policies — 10 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56439Billing and Coding: Blepharoplasty
- A56503Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift
- A56551Billing and Coding: Visual Fields Testing
- A56799Billing and Coding: Visual Fields Testing
Related codes at this level
Codes that share H02.41. If H02.413 is not quite right, the correct code is usually one of these.
Questions about H02.413
- Is H02.413 a billable ICD-10-CM code?
- Yes. H02.413 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H02.413 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).