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H26.20

H26.20: Unspecified complicated cataract

Billable / specific codeICD-10-CM

H26.20 is a billable, specific ICD-10-CM code for unspecified complicated cataract. It is valid for submission on a claim.

Check H26.20 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

  • Cataracta complicata NOS

Excludes1 inherited from the categories above H26.20

A category’s note binds every code beneath it.

Written on H26: Other cataract

  • congenital cataract (Q12.0)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

H26.20 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

  • A56453Billing and Coding: Cataract Extraction
  • A56544Billing and Coding: Cataract Extraction
  • A56549Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation
  • A56613Billing and Coding: Cataract Surgery

Alphabetic index entries that lead here

  • Cataract›complicated

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under H26.2

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.