Blepharophimosis right eye, unspecified eyelid

This code signifies a congenital malformation affecting the right eye, characterized by a reduction in the horizontal opening of the eyelids. It often involves other associated features like ptosis, epicanthus inversus, and telecanthus, collectively known as blepharophimosis syndrome. This specific code indicates that the affected eyelid (upper or lower) is not specified in the documentation.

Use this code when documentation clearly states blepharophimosis affecting the right eye, but does not specify which eyelid (e.g., "blepharophimosis right eye"). This diagnosis is typically made during an ophthalmologic examination, often in infancy or early childhood. Supporting documentation would include physician notes detailing the physical examination findings of the right eye.

• Ensure documentation specifies "right eye" and that the affected eyelid is not further detailed.
• If the affected eyelid (upper or lower) is specified, use a more specific code from the H02.52 subcategory (e.g., H02.521 for right upper eyelid, H02.522 for right lower eyelid).
• Code any associated conditions, such as ptosis (H02.4x) or epicanthus (H02.51x), separately if documented.