ICDcodes.org
FY2027

H59.119 — Intraoperative hemorrhage and hematoma of unspecified eye and adnexa complicating an ophthalmic procedure

BillableUnspecifiedCC

Is H59.119 billable?

Yes, but H59.119 will trip a Medicare edit. H59.119 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists H59.119 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.

H59.119 at a glance

CodeH59.119
DescriptionIntraoperative hemorrhage and hematoma of unspecified eye and adnexa complicating an ophthalmic procedure
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to H59.119?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name H59.119 directly.

Unspecified — a laterality-specific code exists — MCE edit 20

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 H59.119 group to?

H59.119 sits in MDC 21 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 919Complications of Treatment with MCCmedical
  • 920Complications of Treatment with CCmedical
  • 921Complications of Treatment without CC/MCCmedical

As a secondary diagnosis, H59.119 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is H59.119 listed in the Alphabetic Index?

The Alphabetic Index lists these routes under H59.11, the nearest indexed parent of H59.119. Use them to find the family, then select the specific code.

  • Complication › intraoperative › hemorrhage › eye and adnexa › during ophthalmic procedure (s) (from) (of)

Excludes1 — never code together — inherited from H59

The conditions below can never be reported together with H59.119 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • mechanical complication of intraocular lens (T85.2)
  • mechanical complication of other ocular prosthetic devices, implants and grafts (T85.3)
  • pseudophakia (Z96.1)
  • secondary cataracts (H26.4-)

Excludes1 — never code together — inherited from H59.1

The conditions below can never be reported together with H59.119 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • intraoperative hemorrhage and hematoma of eye and adnexa due to accidental puncture or laceration during a procedure (H59.2-)

Excludes2 — not included here — inherited from Chapter 7

The conditions below are not part of H59.119, but a patient may have both at the same time. When documentation supports it, H59.119 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 H59.119 existed?

H59.119 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 H59.11 family? (3)