H04.9 — Disorder of lacrimal system, unspecified
H04.9 is a billable, specific ICD-10-CM code for disorder of lacrimal system, unspecified. It is valid for submission on a claim.
Risk adjustment
H04.9 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
H04.9 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57068Billing and Coding: Ocular Photography - External
How H04.9 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to H04.9.
- Disorder›lacrimal system
Related codes at this level
Codes that share H04. If H04.9 is not quite right, the correct code is usually one of these.
- H04.0Dacryoadenitis
- H04.1Other disorders of lacrimal gland
- 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
Questions about H04.9
- Is H04.9 a billable ICD-10-CM code?
- Yes. H04.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H04.9 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).