ICD-10-CM tabular list

Chapter 7: Diseases of the eye and adnexa

H00-H59

Chapter 7 of the ICD-10-CM tabular list covers diseases of the eye and adnexa, codes H00-H59. It holds 3,466 codes across 12 blocks, of which 2,677 are billable and 789 are header codes that cannot go on a claim. 317 (9%) require a 7th character.

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
endocrine, nutritional and metabolic diseases (E00-E88)
injury (trauma) of eye and orbit (S05.-)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)

Notes

Additional guidance from the ICD-10-CM tabular list.

Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition

Risk adjustment in Chapter 7

52 of this chapter’s codes map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded to the level the record supports.

HCC 298 Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage
HCC 300 Exudative Macular Degeneration
HCC 108 Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major

Excludes2 — not included here, but may coexist

Notes

Risk adjustment in Chapter 7

Blocks in this chapter