ICDcodes.org
FY2027

H04.5 — Stenosis and insufficiency of lacrimal passages

Not billable

Is H04.5 billable?

No — H04.5 is a non-billable header code. H04.5 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 28 billable codes beneath H04.5.

Billable codes under this header

H04.5 at a glance

CodeH04.5
DescriptionStenosis and insufficiency of lacrimal passages
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Excludes1 — never code together — inherited from H04

The conditions below can never be reported together with H04.5 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 H04.5, but a patient may have both at the same time. When documentation supports it, H04.5 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 H04.5, but a patient may have both at the same time. When documentation supports it, H04.5 and the excluded code may both be reported.

What codes fall under H04.5? (7)

How long has H04.5 existed?

H04.5 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.

What other codes are in the H04 family? (8)