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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 H02.413

Billable / Specific

Mechanical ptosis of bilateral eyelids

H02
Block
0
Synonyms
120
LCDs
11
Payer Policies
10
Linked CPTs

About ICD-10-CM H02.413

ICD-10-CM code H02.413 represents Mechanical ptosis of bilateral eyelids. This is a billable/specific code in the Eye and Adnexa chapter (block H02). The 2026 edition of ICD-10-CM H02.413 became effective on October 1, 2025.

Medicare LCD Coverage for H02.413

Local Coverage Determinations (LCDs) from CMS MACs that list H02.413 as a covered diagnosis.

120 LCDs

Showing top 10 of 120 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 67908 →
CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 67915 →
CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 67921 →
CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 67922 →
CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 15823 →
CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 67909 →
CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 67917 →
CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 67923 →
CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 67903 →
CMS LCD: Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
Article ID: 57025, Effective: 2025-01-01 00:00:00, 109 covered, 1 non-covered
CPT 67902 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H02.413.

11 policies

1 Cigna

Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Policy ID: CPG129_EMG_NCV_SSEP

5 Medicare

Billing and Coding: Blepharoplasty
Policy ID: ART-56439
Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift
Policy ID: ART-56503
Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: Visual Fields Testing
Policy ID: ART-56799
Billing and Coding: Blepharoplasty, Blepharoptosis and Brow Lift
Policy ID: ART-56908

CPT Codes Commonly Billed with H02.413

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

10 linkages
  • 67906 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67908 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67902 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 15823 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67901 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67904 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67903 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67900 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 15822 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67909 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD

Convert H02.413 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
H02.413 37433 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 H02.413, Billing FAQ

Is ICD-10 code H02.413 billable? +

Yes, H02.413 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with H02.413? +

Procedures frequently paired with H02.413 include: 67906, 67908, 67902, 15823, 67901.

What ICD-9 codes does H02.413 map to? +

Per CMS GEMs, H02.413 maps to ICD-9 codes: 37433. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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