H26.031
H26.031 — Infantile and juvenile nuclear cataract, right eye
Billable / specific codeICD-10-CMright
H26.031 is a billable, specific ICD-10-CM code for infantile and juvenile nuclear cataract, right eye. It is valid for submission on a claim.
Risk adjustment
H26.031 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
H26.031 is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56453Billing and Coding: Cataract Extraction
- A56453Billing and Coding: Cataract Extraction
- A56544Billing and Coding: Cataract Extraction
- A56549Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation
Related codes at this level
Codes that share H26.03. If H26.031 is not quite right, the correct code is usually one of these.
Questions about H26.031
- Is H26.031 a billable ICD-10-CM code?
- Yes. H26.031 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H26.031 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of lens (H25-H28).