Is Z98.42 a billable ICD-10-CM code?

Yes. Z98.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z98.42 sit in the tabular list?

Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).

What cannot be coded together with Z98.42?

Z98.42 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 Z98.42 (Z98.4) and apply to it just the same.

Z98.42

Z98.42 — Cataract extraction status, left eye

Billable / specific codeICD-10-CMPOA exemptleft

Z98.42 is a billable, specific ICD-10-CM code for cataract extraction status, left eye. It is valid for submission on a claim.

Excludes1 inherited from the categories above Z98.42

These are not written on Z98.42, but they bind it: a note on a category applies to every code beneath it. Billing Z98.42 with anything listed here is a denial.

Written on Z98.4 — Cataract extraction status

aphakia (H27.0)

Excludes2 inherited from the categories above Z98.42

Also inherited, and the opposite of Excludes1: these conditions are not part of Z98.42, but a patient can have both, so you may code both.

Written on Z98 — Other postprocedural states

aftercare (Z43-Z49, Z51)
follow-up medical care (Z08-Z09)
Fontan related circulation (I27.84-)
postprocedural complication - see Alphabetical Index

Risk adjustment

Z98.42 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

Z98.42 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56548Billing and Coding: Corneal Pachymetry
A56816Billing and Coding: Computerized Corneal Topography

Code history

Z98.42 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 Z98.4. If Z98.42 is not quite right, the correct code is usually one of these.

Questions about Z98.42

Is Z98.42 a billable ICD-10-CM code?: Yes. Z98.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z98.42 sit in the tabular list?: Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
What cannot be coded together with Z98.42?: Z98.42 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 Z98.42 (Z98.4) and apply to it just the same.