Is H04.1 a billable ICD-10-CM code?

No. H04.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does H04.1 sit in the tabular list?

Diseases of the eye and adnexa (H00-H59), in the block Disorders of eyelid, lacrimal system and orbit (H00-H05).

H04.1

H04.1 — Other disorders of lacrimal gland

Non-billable headerICD-10-CM

H04.1 is a non-billable header ICD-10-CM code for other disorders of lacrimal gland. It cannot be billed on its own: choose one of the more specific child codes below.

Risk adjustment

H04.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead H04.1

7 child codes. Green means billable.

H04.11Dacryops
H04.12Dry eye syndrome
H04.13Lacrimal cyst
H04.14Primary lacrimal gland atrophy
H04.15Secondary lacrimal gland atrophy
H04.16Lacrimal gland dislocation
H04.19Other specified disorders of lacrimal gland

Related codes at this level

Codes that share H04. If H04.1 is not quite right, the correct code is usually one of these.

H04.0Dacryoadenitis
H04.2Epiphora
H04.3Acute and unspecified inflammation of lacrimal passages
H04.4Chronic inflammation of lacrimal passages
H04.5Stenosis and insufficiency of lacrimal passages
H04.6Other changes of lacrimal passages
H04.8Other disorders of lacrimal system
H04.9Disorder of lacrimal system, unspecified

Questions about H04.1

Is H04.1 a billable ICD-10-CM code?: No. H04.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does H04.1 sit in the tabular list?: Diseases of the eye and adnexa (H00-H59), in the block Disorders of eyelid, lacrimal system and orbit (H00-H05).