ICDcodes.org
FY2027

H21.4 — Pupillary membranes

Not billable

Is H21.4 billable?

No — H21.4 is a non-billable header code. H21.4 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 4 billable codes beneath H21.4.

H21.4 at a glance

CodeH21.4
DescriptionPupillary membranes
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

How is H21.4 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to H21.4. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Membrane, membranous › pupillary (s)

Excludes1 — never code together

The conditions below can never be reported together with H21.4 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 pupillary membranes (Q13.8)

Inclusion terms

Alternative wording in documentation that is classified to H21.4.

  • Iris bombé
  • Pupillary occlusion
  • Pupillary seclusion

Excludes2 — not included here — inherited from Chapter 7

The conditions below are not part of H21.4, but a patient may have both at the same time. When documentation supports it, H21.4 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 H21

The conditions below are not part of H21.4, but a patient may have both at the same time. When documentation supports it, H21.4 and the excluded code may both be reported.

What codes fall under H21.4? (4)

How long has H21.4 existed?

H21.4 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 H21.4?

ICD-10-CM declares these codes mutually exclusive with H21.4 — exactly one of each pair can be correct for a given encounter.

What other codes are in the H21 family? (7)