Is H26.4 a billable ICD-10-CM code?

No. H26.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does H26.4 sit in the tabular list?

Diseases of the eye and adnexa (H00-H59), in the block Disorders of lens (H25-H28).

What cannot be coded together with H26.4?

H26.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H26.4 (H26) and apply to it just the same.

H26.4

H26.4 — Secondary cataract

Non-billable headerICD-10-CM

H26.4 is a non-billable header ICD-10-CM code for secondary cataract. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above H26.4

These are not written on H26.4, but they bind it: a note on a category applies to every code beneath it. Billing H26.4 with anything listed here is a denial.

Written on H26 — Other cataract

congenital cataract (Q12.0)

Other codes that can never be billed with H26.4

These codes carry an Excludes1 note pointing at H26.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading H26.4 alone.

H59Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified

Risk adjustment

H26.4 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.

Code history

H26.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead H26.4

3 child codes. Green means billable.

Related codes at this level

Codes that share H26. If H26.4 is not quite right, the correct code is usually one of these.

Questions about H26.4

Is H26.4 a billable ICD-10-CM code?: No. H26.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does H26.4 sit in the tabular list?: Diseases of the eye and adnexa (H00-H59), in the block Disorders of lens (H25-H28).
What cannot be coded together with H26.4?: H26.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H26.4 (H26) and apply to it just the same.