H04.523
H04.523 — Eversion of bilateral lacrimal punctum
Billable / specific codeICD-10-CMbilateral
H04.523 is a billable, specific ICD-10-CM code for eversion of bilateral lacrimal punctum. It is valid for submission on a claim.
Risk adjustment
H04.523 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.
Medicare coverage
H04.523 is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56439Billing and Coding: Blepharoplasty
- A56503Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift
- A57025Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
- A57068Billing and Coding: Ocular Photography - External
Related codes at this level
Codes that share H04.52. If H04.523 is not quite right, the correct code is usually one of these.
Questions about H04.523
- Is H04.523 a billable ICD-10-CM code?
- Yes. H04.523 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H04.523 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).