2024 ICD-10-CM Diagnosis Code H42

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Bilateral glaucoma of eyes due to plateau iris
• Glaucoma and sleep apnea syndrome
• Glaucoma associated with systemic syndromes
• Glaucoma associated with vascular disorder
• Glaucoma due to combination of mechanisms
• Glaucoma due to congenital anomaly of eye
• Glaucoma due to diabetes mellitus
• Glaucoma due to diabetes mellitus
• Glaucoma due to diabetes mellitus type 1
• Glaucoma due to Lowe syndrome
• Glaucoma due to systemic syndrome
• Glaucoma due to systemic syndrome
• Glaucoma due to systemic syndrome
• Glaucoma due to systemic syndrome
• Glaucoma in endocrine, nutritional and metabolic diseases
• Glaucoma in endocrine, nutritional and metabolic diseases
• Glaucoma in endocrine, nutritional and metabolic diseases
• Glaucoma of bilateral eyes due to systemic disorder
• Glaucoma of left eye due to systemic disorder
• Glaucoma of right eye due to systemic disorder
• Neovascular glaucoma
• Neovascular glaucoma
• Neovascular glaucoma
• Neovascular glaucoma
• Neovascular glaucoma due to diabetes mellitus
• Neovascular glaucoma due to diabetes mellitus
• Neovascular glaucoma due to diabetes mellitus type 1
• Neovascular glaucoma due to diabetes mellitus type 2
• Neovascularization of angle
• Neovascularization of angle
• Neovascularization of angle
• Neovascularization of angle
• Primary glaucoma due to combination of mechanisms
• Rubeosis iridis
• Rubeosis iridis
• Rubeosis iridis
• Rubeosis iridis due to type 1 diabetes mellitus
• Rubeosis iridis due to type 2 diabetes mellitus
• Secondary angle-closure glaucoma
• Sleep apnea

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

• Manifestation diagnoses - Manifestation codes describe the manifestation of an underlying disease, not the disease itself, and therefore should not be used as a principal diagnosis.

H42 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
124	OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT	02	1.3219
125	OTHER DISORDERS OF THE EYE WITHOUT MCC	02	0.7975

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert H42 to ICD-9-CM

• ICD-9-CM Code: 365.44 - Glaucoma w systemic synd
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

Glaucoma

Glaucoma is a group of diseases that can damage the eye's optic nerve. It is a leading cause of blindness in the United States. It usually happens when the fluid pressure inside the eyes slowly rises, damaging the optic nerve. Often there are no symptoms at first. Without treatment, people with glaucoma will slowly lose their peripheral, or side vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains.

A comprehensive eye exam can tell if you have glaucoma. People at risk should get eye exams at least every two years. They include:

• African Americans over age 40
• People over age 60, especially Mexican Americans
• People with a family history of glaucoma

There is no cure, but glaucoma can usually be controlled. Early treatment can help protect your eyes against vision loss. Treatments usually include prescription eyedrops and/or surgery.

NIH: National Eye Institute

[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.