H02.431: Paralytic ptosis of right eyelid
H02.431, paralytic ptosis of right eyelid, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 19 HCPCS Level II codes, including C8900 (Magnetic resonance angiography with contrast, abdomen), C8901 (Magnetic resonance angiography without contrast, abdomen), C8902 (Magnetic resonance angiography without contrast followed…). The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with H02.431 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| C8900 | Magnetic resonance angiography with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8901 | Magnetic resonance angiography without contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8902 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8909 | Magnetic resonance angiography with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8910 | Magnetic resonance angiography without contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8911 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8912 | Magnetic resonance angiography with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8913 | Magnetic resonance angiography without contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8914 | Magnetic resonance angiography without contrast followed by with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8918 | Magnetic resonance angiography with contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8919 | Magnetic resonance angiography without contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8920 | Magnetic resonance angiography without contrast followed by with contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8931 | Magnetic resonance angiography with contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8932 | Magnetic resonance angiography without contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8933 | Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8934 | Magnetic resonance angiography with contrast, upper extremity | Special coverage instructions apply | — | 1 |
| C8935 | Magnetic resonance angiography without contrast, upper extremity | Special coverage instructions apply | — | 1 |
| C8936 | Magnetic resonance angiography without contrast followed by with contrast, upper extremity | Special coverage instructions apply | — | 1 |
| G0255 | Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve | Non-covered by Medicare | Not covered | 5 |
Medicare policy articles listing H02.431
- A57307: Billing and Coding: Nerve Conduction Studies and Electromyography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57478: Billing and Coding: Nerve Conduction Studies and Electromyography (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56775: Billing and Coding: Magnetic Resonance Angiography (Palmetto GBA (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L34424
- A54969: Billing and Coding: Nerve Conduction Studies and Electromyography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57668: Billing and Coding: Nerve Conduction Studies and Electromyography (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56619: Billing and Coding: Nerve Conduction Studies and Electromyography (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other H02 diagnoses (Other disorders of eyelid)
- H02.432 — Paralytic ptosis of left eyelid
- H02.433 — Paralytic ptosis of bilateral eyelids
- H02.041 — Spastic entropion of right upper eyelid
- H02.042 — Spastic entropion of right lower eyelid
- H02.044 — Spastic entropion of left upper eyelid
- H02.045 — Spastic entropion of left lower eyelid
- H02.141 — Spastic ectropion of right upper eyelid
- H02.142 — Spastic ectropion of right lower eyelid
- H02.144 — Spastic ectropion of left upper eyelid
- H02.145 — Spastic ectropion of left lower eyelid
Frequently asked questions
Does Medicare cover H02.431 (Paralytic ptosis of right eyelid)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list H02.431 as a covered diagnosis for 19 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 H02.431?
The Level II codes from the policies most specific to this diagnosis are C8900 (Magnetic resonance angiography with contrast, abdomen, 1 article); C8901 (Magnetic resonance angiography without contrast, abdomen, 1 article); C8902 (Magnetic resonance angiography without contrast followed…, 1 article); C8909 (Magnetic resonance angiography with contrast, chest…, 1 article); C8910 (Magnetic resonance angiography without contrast, chest…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list H02.431?
A57307 (Billing and Coding: Nerve Conduction Studies and Electromyography); A57478 (Billing and Coding: Nerve Conduction Studies and Electromyography); A56775 (Billing and Coding: Magnetic Resonance Angiography), and 3 more articles.
What is ICD-10-CM code H02.431?
H02.431 is the ICD-10-CM code for paralytic ptosis of right eyelid, in category H02 (Other disorders of eyelid), chapter 7: Diseases of the eye and adnexa.
Next steps
- Run a reimbursement report for a device billed under C8900
- Watch C8900 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C8900
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 7: Diseases of the eye and adnexa · All diagnoses · HCPCS lookup