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H04.213

H04.213: Epiphora due to excess lacrimation, bilateral lacrimal glands

Billable / specific codeICD-10-CMbilateral

H04.213 is a billable, specific ICD-10-CM code for epiphora due to excess lacrimation, bilateral lacrimal glands. It is valid for submission on a claim.

Check H04.213 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above H04.213

A category’s note binds every code beneath it.

Written on H04: Disorders of lacrimal system

  • congenital malformations of lacrimal system (Q10.4-Q10.6)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

H04.213 is named in 1 Medicare coverage policy: 0 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.

  • A57284Billing and Coding: Nasal Punctum-Nasolacrimal Duct Dilation and Probing with or without Irrigationnot covered

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under H04.21

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.