Glaucoma in diseases classified elsewhere
In Glaucoma (H40-H42), chapter 7: Diseases of the Eye and Adnexa
- H42 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under H40-H42 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 H40-H42
Glaucoma (H40-H42)
- H40Glaucoma
- H42Glaucoma in diseases classified elsewhere(this code)
H42 MS-DRGs
As the principal diagnosis, H42 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.
H42 is in Glaucoma (EYE003), with 273 codes. Others in it:
Medicare coverage articles listing H42
These 7 Medicare billing and coding articles list H42 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.
- Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) (4 contractors)
- Corneal Pachymetry (2 contractors)
- Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) (2 contractors)
- Visual Fields Testing (2 contractors)
- Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- Visual Field Examination
- Visual Fields
Other codes that refer to H42
Notes on these codes point to H42.
- E08.39 Use Additional Code: diabetic glaucoma (H40-H42)
- E09.39 Use Additional Code: diabetic glaucoma (H40-H42)
- E10.39 Use Additional Code: diabetic glaucoma (H40-H42)
- E11.39 Use Additional Code: diabetic glaucoma (H40-H42)
- E13.39 Use Additional Code: diabetic glaucoma (H40-H42)
- E72.03 Use Additional Code: code for associated glaucoma (H42)
- H26.23 Code First: underlying glaucoma (H40-H42)
- Q13.1 Use Additional Code: code for associated glaucoma (H42)
- Q13.81 Use Additional Code: code for associated glaucoma (H42)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Glaucoma
Glaucoma is a group of diseases that can damage the optic nerve of one, or both, of your eyes. This can result in vision loss. There are different types of glaucoma, but the most common type is open-angle glaucoma. Other less common types include angle-closure glaucoma, and congenital glaucoma.
Read more about glaucoma 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).
- 365.44 Glaucoma associated with systemic syndromes (approximate)