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H01.143

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🧬 ICD-10 CM H01.143 - Xeroderma of right eye, unspecified eyelid

Short Definition

Xeroderma (pathologically dry, rough, scaly skin) of the eyelid region of the right eye, with unspecified involvement of the upper vs lower lid.

Long Definition

ICD-10 CM H01.143 represents xeroderma of the eyelid of the right eye when the provider documents abnormal dryness and roughness of the right eyelid skin—often accompanied by scaling, flaking, fine fissuring, erythema, and pruritus—without primary infection and without specifying whether the upper or lower lid is involved. It sits under the H01.1 noninfectious dermatoses of eyelid group, reflecting an inflammatory dermatologic process of the eyelid skin rather than an infectious blepharitis, and is most often associated with atopic dermatitis, contact/irritant dermatitis from cosmetics or topical medications, seborrheic dermatitis involving the eyelashes and lid margins, or chronic environmental exposure leading to lid-skin barrier disruption. Clinically, patients frequently report itching, burning, tightness, cosmetic concerns (flaking, redness), and sometimes swelling or thickening; on exam, the right periocular region shows dry, rough, scaly or lichenified skin at the lid margin and/or periorbital skin, with or without erythema, but without characteristic collarettes or lash-base debris of classic anterior blepharitis and without purulence or cellulitis. Xeroderma itself is not an infection; it is a manifestation of barrier dysfunction and inflammation of the thin eyelid skin, which is particularly susceptible to allergens and irritants because it is among the thinnest skin in the body and highly vascular. Common precipitating factors include new eye makeup (mascara, eyeliner, shadow), eyelash serums, facial cleansers or wipes, antiaging creams (retinoids, AHAs), topical ophthalmic medications with preservatives (benzalkonium chloride), occupational exposures (dust, solvents), systemic dermatoses such as atopic dermatitis, and environmental dryness (seasonal low humidity, forced-air heating).

From a coding perspective, H01.143 is appropriate when documentation clearly states xeroderma of the right eyelid or equivalent terms such as “dry, scaly dermatitis of right eyelid,” and the provider does not specify whether the upper or lower lid is involved. If upper vs lower lid is explicitly documented, the more specific codes H01.141 (right upper) or H01.142 (right lower) should be chosen instead; H01.143 is reserved for “right eye, unspecified eyelid” situations where documentation is laterally specific at the eye level (OD) but not at the lid segment. The code denotes a noninfectious dermatosis, so it should not be used when the primary process is infectious blepharitis, cellulitis, or hordeolum; in those cases, blepharitis or eyelid infection codes under H00 or other infection chapters are more accurate. H01.143 can coexist with conjunctival or corneal diagnoses (e.g., dry eye, keratoconjunctivitis) if ocular surface involvement is documented, but each should be coded separately according to provider documentation. Management usually includes avoidance of triggers (elimination of offending cosmetics or topical agents), gentle fragrance-free cleansers, bland emollients or barrier creams suitable for periocular use, short courses of low-potency topical corticosteroids or calcineurin inhibitors when indicated, and treatment of associated ocular surface disease (artificial tears, lid hygiene) if present.

Area of Body

Primary anatomic structures involved (right eye):

  • Right eyelids (upper and/or lower, unspecified):

    • Epidermis and superficial dermis of the right eyelid skin.

    • Lid margin skin at lash base may be involved.

  • Periocular skin of right eye:

    • Skin immediately surrounding the lid margin, especially lateral and medial canthal areas.

Secondary structures potentially affected:

  • Eyelash follicles: Chronic inflammation can alter lash direction or density over time.

  • Conjunctiva/cornea: May be secondarily irritated from flaking debris, rubbing, or topical medications, but this is not inherent to H01.143 and would require separate codes if clinically significant.

Includes

Assign H01.143 when documentation for the right eye supports:

  • “Xeroderma of right eyelid” with no specification of upper vs lower.

  • “Dry, scaly right eyelid skin,” “chronic dry dermatitis of right eyelid,” or “chronic eczematous dry lid OD” when the provider aligns this with xeroderma rather than a different dermatosis subtype.

  • Noninfectious, dry, eczematous-type dermatitis of the right eyelid driven by:

    • Atopic dermatitis with periocular involvement.

    • Chronic irritant dermatitis from soaps, cleansers, or environmental exposures.

    • Allergic contact dermatitis to cosmetics, skin-care products, nail polish (hand-eye transfer), or topical eye medications.

    • Low-humidity environmental exposure (e.g., winter dry air) leading to eyelid xerosis.

  • Cases where the provider uses terms like:

    • “Xerosis” or “xeroderma” of right eyelid.

    • “Periocular eczema/dryness OD” and correlates this to ICD-10 xeroderma of eyelid.

  • Encounters where the eyelid xeroderma is the chief complaint or primary focus of care (e.g., dermatology consult for eyelid rash, ophthalmology visit for periocular dermatitis).

Note

H01.143 is particularly appropriate when the right eye is clearly identified (OD) but the documentation does not split findings into upper vs lower lid, or when the provider explicitly says “right eye eyelids” or “both right lids” without separate lid-level coding.

Excludes

Conceptual Excludes1 situations (mutually exclusive as primary diagnosis for the same manifestation):

Do not use H01.143 when the primary condition is:

  1. Specific blepharitis types (H01.0x-):

  2. Other noninfectious dermatoses of eyelid (H01.11-H01.13, H01.15-H01.19) when clearly specified:

    • Allergic dermatitis of eyelid (H01.11x).

    • Discoid lupus erythematosus of eyelid (H01.12x).

    • Eczematous dermatitis of eyelid (H01.13x).

    • Other specifically named dermatoses in H01.15-H01.19.

    • If the provider documents “allergic contact dermatitis of right eyelid” or “eczema of right eyelid,” use the matching allergic/eczema code instead of xeroderma.

  3. Infectious eyelid disease (H00.-, L03.-, etc.):

    • Hordeolum (stye), chalazion (H00.0x, H00.1x).

    • Preseptal cellulitis (L03.2x or H00.03x depending on documentation).

    • Blepharoconjunctivitis (H10.5x).

    • These represent infections, not noninfectious xerosis.

  4. Systemic dermatologic conditions coded elsewhere:

    • Psoriasis (L40.-) with eyelid involvement should be coded with systemic dermatosis plus appropriate eye manifestation if separately documented.

    • Rosacea (L71.-) with ocular involvement (H10.82, etc.).

    • If the provider clearly links the eyelid changes to a named systemic dermatosis, code that primary dermatosis and use H01.143 only if they also explicitly diagnose xeroderma of eyelid as a separate condition.

Excludes2-style considerations (can co-exist, code both when documented):

  • Keratoconjunctivitis sicca (dry eye) - H16.22x/H16.23x: may coexist with eyelid xeroderma; both can be coded if both are clinically addressed.

  • Allergic conjunctivitis (H10.1x) or chronic conjunctivitis - can co-occur if dryness/debris from lid skin causes ocular irritation.

  • Systemic atopic dermatitis (L20.-) - can be coded alongside H01.143 if the eyelid manifestation is specifically documented as xeroderma.

HCC Status

  • Direct HCC mapping: H01.143 does not map to any CMS-HCC category.

  • As an isolated eye/eyelid skin diagnosis, it does not contribute directly to risk adjustment scores.

Indirect considerations:

  • It may coexist with chronic systemic conditions that do map to HCCs (e.g., diabetes, COPD, heart failure), but H01.143 itself is not an HCC driver.

  • In risk adjustment audits, eyelid dermatoses serve more as clinical context than as RAF-impacting diagnoses.

MS-DRG Status

  • MS-DRG role: H01.143 is typically a minor secondary diagnosis in inpatient settings and is much more common in outpatient care.

  • It generally will not change the DRG from “without CC/MCC” to “with CC/MCC,” as it is not recognized as a CC/MCC in most grouper tables.

  • Most encounters for eyelid xeroderma are outpatient and do not involve DRG-based payment.

Inpatient use:

  • When documented in a hospitalized patient (for other reasons, e.g., stroke, sepsis), H01.143:

    • Can support complexity of nursing skin/eye care (lubricants, avoidance of irritants).

    • Typically does not impact facility reimbursement in any significant way.

wRVU / Assistant Payable

  • wRVU: Not applicable to H01.143 (diagnosis-only).

    • Work RVUs apply to CPT/HCPCS procedures and E/M services.

    • The presence of H01.143 may justify higher-complexity ophthalmic or E/M codes if the evaluation/management work is more extensive (history, exam, counseling), but the wRVUs belong to those CPT codes, not to the ICD-10 code itself.

  • Assistant surgeon payable: Not applicable.

    • Assistant surgeon indicators and payments apply to surgical CPT codes (e.g., eyelid reconstruction, blepharoplasty, lesion excision).

    • Xeroderma of eyelid itself is treated medically or, rarely, with minor procedures that usually do not require a formal assistant surgeon.

Code Tree / Hierarchy

ICD-10-CM Position:

Chapter 7: H00-H59 - Diseases of the eye and adnexa
│
└── H00-H05 - Disorders of eyelid, lacrimal system and orbit
    │
    └── H01 - Other inflammation of eyelid
        │
        ├── H01.0 - Blepharitis
        │   ├── H01.00 - Unspecified blepharitis
        │   ├── H01.01 - Ulcerative blepharitis
        │   └── H01.02 - Squamous blepharitis
        │
        ├── H01.1 - Noninfectious dermatoses of eyelid
        │   │
        │   ├── H01.11 - Allergic dermatitis of eyelid
        │   ├── H01.12 - Discoid lupus erythematosus of eyelid
        │   ├── H01.13 - Eczematous dermatitis of eyelid
        │   ├── H01.14 - Xeroderma of eyelid
        │   │   ├── H01.141 - Xeroderma of right upper eyelid
        │   │   ├── H01.142 - Xeroderma of right lower eyelid
        │   │   ├── H01.143 - Xeroderma of right eye, unspecified eyelid   ◄ CURRENT CODE
        │   │   ├── H01.144 - Xeroderma of left upper eyelid
        │   │   ├── H01.145 - Xeroderma of left lower eyelid
        │   │   ├── H01.146 - Xeroderma of left eye, unspecified eyelid
        │   │   └── H01.149 - Xeroderma of unspecified eye, unspecified eyelid
        │   │
        │   ├── H01.15-H01.19 - Other specified noninfectious dermatoses of eyelid
        │
        └── H01.8-H01.9 - Other specified/unspecified inflammation of eyelid```

Laterality and specificity within H01.14 (xeroderma of eyelid):

  • H01.141 - Right upper eyelid.

  • H01.142 - Right lower eyelid.

  • H01.143 - Right eye, unspecified eyelid.

  • H01.144 - Left upper eyelid.

  • H01.145 - Left lower eyelid.

  • H01.146 - Left eye, unspecified eyelid.

  • H01.149 - Unspecified eye, unspecified eyelid.

Note

Coding best practice: pick the most specific lid-level code whenever documentation allows; default to eye-level unspecified lid (H01.143) only if the provider does not specify upper vs lower.

Common Associated Codes

Frequently co-coded diagnoses:

ICD-10 CodeDescriptionHow it relates to H01.143
H01.13xEczematous dermatitis of eyelidOverlapping clinical spectrum; use if provider documents “eczema” rather than “xeroderma”
H10.10-H10.13Acute atopic/allergic conjunctivitisCan co-exist with periocular dermatitis from allergens
H16.22xKeratoconjunctivitis sicca (dry eye)Common comorbid condition in generalized ocular surface dryness
L20.8/L20.9Atopic dermatitisSystemic skin disease driving eyelid xeroderma
L23.-Allergic contact dermatitisCan be the underlying pathophysiology of eyelid dryness/redness
L24.-Irritant contact dermatitisSoaps, solvents, topical agents affecting eyelid skin
L85.3Xerosis cutisGeneralized dry skin; H01.143 is the eyelid-specific manifestation
H00.15xHordeolum (if secondary infection occurs)Not usually coded together unless new infectious complication documented

Common CPT pairings (for reference):

CPT CodeDescriptionTypical H01.143 Usage Context
92002/92004New patient ophthalmic examInitial workup of eyelid dermatitis/xeroderma
92012/92014Established patient ophthalmic examFollow-up on chronic eyelid dryness/dermatitis
99202-99215Office/outpatient E/MUsed when primary provider is not ophthalmology
92285External ocular photographyTo document extent of periocular skin findings
67820Epilation (permanent/temporary)If chronic lid dermatosis leads to trichiasis; uncommon

Coding Examples

Example 1 - Simple Xeroderma of Right Eyelid (Unspecified Lid)

Scenario:

  • 42-year-old woman presents to ophthalmology complaining of “dry, flaky skin around my right eye.”

  • Exam: Right eyelid skin with scaling, mild erythema, fine fissures; no signs of infection or classic collarettes at lash bases; left eye normal.

  • Provider documents: “Xeroderma of right eyelid, likely irritant dermatitis from new makeup remover. No blepharitis. No conjunctivitis.”

ICD-10-CM:

  • H01.143 - Xeroderma of right eye, unspecified eyelid.

CPT (example):

  • 92012 - Intermediate established patient ophthalmic exam.

Notes:

  • Lid (upper vs lower) not specified → H01.143 is appropriate.

  • No infection → do not use blepharitis code.

  • Counseling provided on discontinuing irritant product and using bland emollient.

Example 2 - Atopic Dermatitis with Right Eyelid Xeroderma

Scenario:

  • 25-year-old known atopic dermatitis patient presents to dermatology.

  • Findings: Widespread eczema, including periocular region with dry scaly skin on both lids of the right eye; provider’s assessment: “Atopic dermatitis flare with xeroderma of right eyelid.”

  • Lids not separated into upper vs lower in note.

ICD-10-CM:

  • L20.9 - Atopic dermatitis, unspecified (or more specific L20.8 if documented).

  • H01.143 - Xeroderma of right eye, unspecified eyelid.

CPT (example):

  • 99214 - Established patient E/M with moderate complexity (systemic condition plus periocular involvement).

Notes:

  • Atopic dermatitis is systemic; H01.143 documents specific eyelid manifestation.

  • Combined coding reflects both systemic disease and local eyelid xerosis.

Example 3 - Cosmetic Contact Dermatitis Resulting in Xeroderma OD

Scenario:

  • 35-year-old female, new eyeliner and mascara use; presents with itchy, flaky skin along right eyelid margin.

  • Exam: Right eyelid with dry scaly skin at lash line and peri-lid area; mild erythema; no purulence; no lash loss.

  • Assessment: “Allergic contact dermatitis causing xeroderma of right eyelid from new cosmetic.”

ICD-10-CM:

  • L23.2 - Allergic contact dermatitis due to cosmetics (if specified).

  • H01.143 - Xeroderma of right eye, unspecified eyelid.

CPT (example):

  • 99213 - Established patient office visit (if in primary care or derm).

Notes:

  • If the provider only explicitly codes the contact dermatitis and uses “xeroderma” descriptively, you may or may not add H01.143 depending on your documentation standard; when they clearly state both “allergic contact dermatitis” and “xeroderma of eyelid” as diagnoses, code both.

Example 4 - Distinguishing from Blepharitis

Scenario:

  • 60-year-old man presents with “dry eyelids OD.”

  • Exam:

    • Right lid: dry, scaly skin, mild erythema, but no lash base crusting, no collarettes, no meibomian orifices plugging.

    • Diagnosis: “Xeroderma of right eyelid; no evidence of anterior/posterior blepharitis.”

ICD-10-CM:

  • H01.143 - Xeroderma of right eye, unspecified eyelid.

Incorrect coding to avoid:

  • H01.001-H01.003 (unspecified blepharitis) - do not use if the provider explicitly says there is no blepharitis.

Example 5 - Need for Greater Specificity (Upper vs Lower Lid)

Scenario:

  • 50-year-old presents with dryness, scaling confined to the right upper eyelid.

  • Documentation: “Xeroderma of right upper eyelid.”

Best ICD-10-CM:

  • H01.141 - Xeroderma of right upper eyelid.

NOT H01.143.

H01.143 should only be chosen when the eyelid segment (upper vs lower) is unspecified. If your provider routinely documents only “right eyelid,” you could encourage them to specify upper vs lower to allow more specific ICD-10 coding.

Documentation Tips for H01.143

To support accurate coding of H01.143:

  1. Clearly state the diagnosis:

    • Use the term “xeroderma,” “xerosis,” or equivalent (e.g., “very dry scaly eyelid skin”).

    • Indicate that this is a noninfectious dermatosis rather than an infection.

  2. Specify laterality at least at eye level:

    • “Right eye,” “OD,” or “right eyelid(s)” should be clearly documented.

    • Add upper vs lower when possible for more specific coding.

  3. Differentiate from blepharitis:

    • If blepharitis is absent, state that there is no lash-base inflammation/infection.

    • If both blepharitis and xeroderma exist, code both only if they are documented as separate problems.

  4. Mention suspected cause if known:

    • Contact irritants (cosmetics, cleansers).

    • Atopic/systemic dermatoses.

    • Environmental factors.

  5. Document severity and impact:

    • Impact on vision, comfort, or function (e.g., difficulty blinking due to tightness).

    • Presence of fissures or pre-ulcerative changes.

  6. Outline treatment plan:

    • Avoidance of triggers.

    • Emollients/barrier creams.

    • Short-term topical steroids or calcineurin inhibitors if indicated.

    • Education about safe periocular product use.

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