Is H04.43 a billable ICD-10-CM code?

No. H04.43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does H04.43 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).

H04.43

H04.43 — Chronic lacrimal mucocele

Non-billable headerICD-10-CM

H04.43 is a non-billable header ICD-10-CM code for chronic lacrimal mucocele. It cannot be billed on its own: choose one of the more specific child codes below.

Risk adjustment

H04.43 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 H04.43

4 child codes. Green means billable.

H04.431Chronic lacrimal mucocele of right lacrimal passage
H04.432Chronic lacrimal mucocele of left lacrimal passage
H04.433Chronic lacrimal mucocele of bilateral lacrimal passages
H04.439Chronic lacrimal mucocele of unspecified lacrimal passage

Related codes at this level

Codes that share H04.4. If H04.43 is not quite right, the correct code is usually one of these.

H04.41Chronic dacryocystitis
H04.42Chronic lacrimal canaliculitis

Questions about H04.43

Is H04.43 a billable ICD-10-CM code?: No. H04.43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does H04.43 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).