Cataract in diseases classified elsewhere
In Disorders of lens (H25-H28), chapter 7: Diseases of the Eye and Adnexa
- H28 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under H25-H28 below.
- As a secondary diagnosis it is not a CC or MCC, so it doesn't raise the MS-DRG payment.
- Doesn't count toward a Medicare Advantage risk score (no HCC in V28).
- AHRQ's Chronic Condition Indicator classes it as chronic: expected to last 12 months or longer and to limit daily life or need ongoing care.
- Can't be the principal diagnosis: code the underlying condition first. (Manifestation list)
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Instructional notes
Excludes1: not coded here, use a different code
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Covers coding glaucoma by type, eye, and stage, including bilateral cases and stage changes, and coding blindness or low vision when the impairment category is undocumented.
Other codes under H25-H28
Disorders of lens (H25-H28)
- H25Age-related cataract
- H26Other cataract
- H27Other disorders of lens
- H28Cataract in diseases classified elsewhere(this code)
H28 MS-DRGs
As the principal diagnosis, H28 groups to MS-DRG 124 or 125 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
H28 is in Cataract and other lens disorders (EYE002), with 124 codes. Others in it:
- E08.36 Diabetes mellitus due to underlying condition with diabetic cataract
- E09.36 Drug or chemical induced diabetes mellitus with diabetic cataract
- E10.36 Type 1 diabetes mellitus with diabetic cataract
- E11.36 Type 2 diabetes mellitus with diabetic cataract
- E13.36 Other specified diabetes mellitus with diabetic cataract
- H25.011 Cortical age-related cataract, right eye
- H25.012 Cortical age-related cataract, left eye
- H25.013 Cortical age-related cataract, bilateral
Medicare coverage articles listing H28
These 6 Medicare billing and coding articles list H28 as a diagnosis that supports medical necessity for the services they cover. From the CMS Medicare Coverage Database; check your own contractor's article before billing.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Cataract
A cataract is a clouding of the clear lens inside your eye. This cloudiness blocks light from reaching the back of the eye, making it harder to see clearly. A cataract can affect one or both eyes, but it doesn't spread from one eye to the other.
Read more about cataract on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 366.44 Cataract associated with other syndromes (approximate)