Is H59.021 a billable ICD-10-CM code?

Yes. H59.021 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

What cannot be coded together with H59.021?

H59.021 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 H59.021 (H59) and apply to it just the same.

H59.021

H59.021 — Cataract (lens) fragments in eye following cataract surgery, right eye

Billable / specific codeICD-10-CMright

H59.021 is a billable, specific ICD-10-CM code for cataract (lens) fragments in eye following cataract surgery, right eye. It is valid for submission on a claim.

Excludes1 inherited from the categories above H59.021

These are not written on H59.021, but they bind it: a note on a category applies to every code beneath it. Billing H59.021 with anything listed here is a denial.

Written on H59 — Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified

mechanical complication of intraocular lens (T85.2)
mechanical complication of other ocular prosthetic devices, implants and grafts (T85.3)
pseudophakia (Z96.1)
secondary cataracts (H26.4-)

Risk adjustment

H59.021 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

H59.021 is named in 9 Medicare coverage policies — 9 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
A56453Billing and Coding: Cataract Extraction
A56544Billing and Coding: Cataract Extraction
A56613Billing and Coding: Cataract Surgery

Code history

H59.021 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share H59.02. If H59.021 is not quite right, the correct code is usually one of these.

Questions about H59.021

Is H59.021 a billable ICD-10-CM code?: Yes. H59.021 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H59.021 sit in the tabular list?: Diseases of the eye and adnexa (H00-H59), in the block Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified (H59).
What cannot be coded together with H59.021?: H59.021 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 H59.021 (H59) and apply to it just the same.