H40.42X4 — Glaucoma secondary to eye inflammation, left eye, indeterminate stage
H40.42X4 is a billable, specific ICD-10-CM code for glaucoma secondary to eye inflammation, left eye, indeterminate stage. It is valid for submission on a claim.
7th character "4" — indeterminate stage
One of the following 7th characters is to be assigned to each code in subcategory H40.4 to designate the stage of glaucoma
- 0
- stage unspecified
- 1
- mild stage
- 2
- moderate stage
- 3
- severe stage
- 4
- indeterminate stage
Risk adjustment
H40.42X4 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
H40.42X4 is named in 21 Medicare coverage policies — 21 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A55639Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
- A56457Billing and Coding: Corneal Pachymetry
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Related codes at this level
Codes that share H40.42. If H40.42X4 is not quite right, the correct code is usually one of these.
Questions about H40.42X4
- Is H40.42X4 a billable ICD-10-CM code?
- Yes. H40.42X4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H40.42X4 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Glaucoma (H40-H42).