H26.20 — Unspecified complicated cataract
H26.20 is a billable, specific ICD-10-CM code for unspecified complicated cataract. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Cataracta complicata NOS
Risk adjustment
H26.20 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
H26.20 is named in 9 Medicare coverage policies — 9 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
How H26.20 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 H26.20.
- Cataract›complicated
Related codes at this level
Codes that share H26.2. If H26.20 is not quite right, the correct code is usually one of these.
Questions about H26.20
- Is H26.20 a billable ICD-10-CM code?
- Yes. H26.20 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H26.20 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of lens (H25-H28).