H42

H42: Glaucoma in diseases classified elsewhere

Billable / specific codeICD-10-CM

H42 is a billable, specific ICD-10-CM code for glaucoma in diseases classified elsewhere. It is valid for submission on a claim.

Check H42 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

glaucoma (in) onchocerciasis (B73.02)
glaucoma (in) syphilis (A52.71)
glaucoma (in) tuberculous (A18.59)
neovascular secondary angle closure glaucoma (H40.84-)

Code first

The underlying condition must be sequenced before this code.

underlying condition, such as:
amyloidosis (E85.-)
aniridia (Q13.1)
glaucoma (in) diabetes mellitus (E08.39, E09.39, E10.39, E11.39, E13.39)
Lowe's syndrome (E72.03)
Rieger anomaly (Q13.81)
specified metabolic disorder (E70-E88)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

H42 is named in 13 Medicare coverage policies: 13 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
A56457Billing and Coding: Corneal Pachymetry
A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
A56548Billing and Coding: Corneal Pachymetry

Code history

Unchanged in every release from FY2024 to FY2027.