H43.0 vs H59
H43.0 and H59 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on H43.0
vitreous syndrome following cataract surgery (H59.0-)
H43.0
Vitreous prolapse
Not billable
- Chapter 7
- Diseases of the eye and adnexa
- Section
- H43-H44
Indexed under
- Prolapse, prolapsed › vitreous
H59
Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified
Not billable
- Chapter 7
- Diseases of the eye and adnexa
- Section
- H59
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027