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H16.259

H16.259Phlyctenular keratoconjunctivitis, unspecified eye

Billable / specific codeICD-10-CMunspecified

H16.259 is a billable, specific ICD-10-CM code for phlyctenular keratoconjunctivitis, unspecified eye. It is valid for submission on a claim.

Risk adjustment

H16.259 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

H16.259 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.

  • A57637Billing and Coding: Visual Field Examination

Related codes at this level

Codes that share H16.25. If H16.259 is not quite right, the correct code is usually one of these.

Questions about H16.259

Is H16.259 a billable ICD-10-CM code?
Yes. H16.259 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H16.259 sit in the tabular list?
Diseases of the eye and adnexa (H00-H59), in the block Disorders of sclera, cornea, iris and ciliary body (H15-H22).
ICD-10-CMFY2026-Apr· effective April 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.