MCMedicalCodingSoftware
H04.5

H04.5: Stenosis and insufficiency of lacrimal passages

Non-billable headerICD-10-CM

H04.5 is a non-billable header ICD-10-CM code for stenosis and insufficiency of lacrimal passages. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above H04.5

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.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead H04.5

7 child codes. Green means billable.

Other codes under H04

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.