Z98.42 — Cataract extraction status, left eye
Is Z98.42 billable?
Yes — Z98.42 is billable for FY2027. Z98.42 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z98.42 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z98.42 at a glance
| Code | Z98.42 |
|---|---|
| Description | Cataract extraction status, left eye |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z98.42?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z98.42 directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does Z98.42 group to?
Z98.42 sits in MDC 23 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 951Other Factors Influencing Health Statusmedical
How is Z98.42 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under Z98.4, the nearest indexed parent of Z98.42. Use them to find the family, then select the specific code.
- Cataract › extraction status (cortical) (immature) (incipient)
- Status › cataract extraction (post)
- Absence › lens › post cataract extraction (of) (organ or part) (complete or partial)
Excludes1 — never code together — inherited from Z98.4
The conditions below can never be reported together with Z98.42 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- aphakia (H27.0)
Use additional code — inherited from Z98.4
Report an additional code alongside Z98.42 to fully describe the condition. Z98.42 is sequenced first.
- code to identify intraocular lens implant status (Z96.1)
Excludes2 — not included here — inherited from Z98
The conditions below are not part of Z98.42, but a patient may have both at the same time. When documentation supports it, Z98.42 and the excluded code may both be reported.
Code also — inherited from Z77-Z99
Two codes may be needed to describe the condition fully. Whether Z98.42 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z98.42 existed?
Z98.42 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.