H28 — Cataract in diseases classified elsewhere
H28 is a billable, specific ICD-10-CM code for cataract in diseases classified elsewhere. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Code first
The underlying condition must be sequenced before this code.
Risk adjustment
H28 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
H28 is named in 12 Medicare coverage policies — 12 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
- A56549Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation
- A56613Billing and Coding: Cataract Surgery
Code history
H28 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Questions about H28
- Is H28 a billable ICD-10-CM code?
- Yes. H28 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H28 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 H28?
- H28 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter.