H44.009 — Unspecified purulent endophthalmitis, unspecified eye
Is H44.009 billable?
Yes, but H44.009 will trip a Medicare edit. H44.009 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists H44.009 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
H44.009 at a glance
| Code | H44.009 |
|---|---|
| Description | Unspecified purulent endophthalmitis, unspecified eye |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to H44.009?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name H44.009 directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does H44.009 group to?
H44.009 sits in MDC 02 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 121Acute Major Eye Infections with CC/MCCmedical
- 122Acute Major Eye Infections without CC/MCCmedical
As a secondary diagnosis, H44.009 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is H44.009 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to H44.009. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Endophthalmitis (acute) (infective) (metastatic) (subacute)
Excludes1 — never code together — inherited from H44.0
The conditions below can never be reported together with H44.009 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- bleb associated endophthalmitis (H59.4-)
Use additional code — inherited from H44.0
Report an additional code alongside H44.009 to fully describe the condition. H44.009 is sequenced first.
- code to identify organism
Excludes2 — not included here — inherited from Chapter 7
The conditions below are not part of H44.009, but a patient may have both at the same time. When documentation supports it, H44.009 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)
How long has H44.009 existed?
H44.009 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.