H40.1111 — Primary open-angle glaucoma, right eye, mild stage
H40.1111 is a billable, specific ICD-10-CM code for primary open-angle glaucoma, right eye, mild stage. It is valid for submission on a claim.
7th character "1" — mild stage
One of the following 7th characters is to be assigned to each code in subcategory H40.11 to designate the stage of glaucoma
- 0
- stage unspecified
- 1
- mild stage
- 2
- moderate stage
- 3
- severe stage
- 4
- indeterminate stage
Risk adjustment
H40.1111 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
H40.1111 is named in 42 Medicare coverage policies — 42 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52432Billing and Coding: Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach (0192T 66183)
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A55639Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
- A56457Billing and Coding: Corneal Pachymetry
Related codes at this level
Codes that share H40.111. If H40.1111 is not quite right, the correct code is usually one of these.
Questions about H40.1111
- Is H40.1111 a billable ICD-10-CM code?
- Yes. H40.1111 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H40.1111 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Glaucoma (H40-H42).