H04.3 — Acute and unspecified inflammation of lacrimal passages
Is H04.3 billable?
No — H04.3 is a non-billable header code. H04.3 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 16 billable codes beneath H04.3.
Billable codes under this header
- H04.301Unspecified dacryocystitis of right lacrimal passage
- H04.302Unspecified dacryocystitis of left lacrimal passage
- H04.303Unspecified dacryocystitis of bilateral lacrimal passages
- H04.309Unspecified dacryocystitis of unspecified lacrimal passage
- H04.311Phlegmonous dacryocystitis of right lacrimal passage
- H04.312Phlegmonous dacryocystitis of left lacrimal passage
- H04.313Phlegmonous dacryocystitis of bilateral lacrimal passages
- H04.319Phlegmonous dacryocystitis of unspecified lacrimal passage
- H04.321Acute dacryocystitis of right lacrimal passage
- H04.322Acute dacryocystitis of left lacrimal passage
- H04.323Acute dacryocystitis of bilateral lacrimal passages
- H04.329Acute dacryocystitis of unspecified lacrimal passage
- H04.331Acute lacrimal canaliculitis of right lacrimal passage
- H04.332Acute lacrimal canaliculitis of left lacrimal passage
- H04.333Acute lacrimal canaliculitis of bilateral lacrimal passages
- H04.339Acute lacrimal canaliculitis of unspecified lacrimal passage
H04.3 at a glance
| Code | H04.3 |
|---|---|
| Description | Acute and unspecified inflammation of lacrimal passages |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes1 — never code together
The conditions below can never be reported together with H04.3 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- neonatal dacryocystitis (P39.1)
Excludes1 — never code together — inherited from H04
The conditions below can never be reported together with H04.3 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- congenital malformations of lacrimal system (Q10.4-Q10.6)
Excludes2 — not included here — inherited from Chapter 7
The conditions below are not part of H04.3, but a patient may have both at the same time. When documentation supports it, H04.3 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury (trauma) of eye and orbit (S05.-)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)
Excludes2 — not included here — inherited from H00-H05
The conditions below are not part of H04.3, but a patient may have both at the same time. When documentation supports it, H04.3 and the excluded code may both be reported.
What codes fall under H04.3? (4)
How long has H04.3 existed?
H04.3 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
Which codes are confused with H04.3?
ICD-10-CM declares these codes mutually exclusive with H04.3 — exactly one of each pair can be correct for a given encounter.
What other codes are in the H04 family? (8)
- H04.0Dacryoadenitisnot billable
- H04.1Other disorders of lacrimal glandnot billable
- H04.2Epiphoranot billable
- H04.4Chronic inflammation of lacrimal passagesnot billable
- H04.5Stenosis and insufficiency of lacrimal passagesnot billable
- H04.6Other changes of lacrimal passagesnot billable
- H04.8Other disorders of lacrimal systemnot billable
- H04.9Disorder of lacrimal system, unspecified