2027 ICD-10-CM Diagnosis Code H01.125Discoid lupus erythematosus of left lower eyelid
ICD-10-CM Codes›H00–H59›H00-H05›H01
- Billable — Valid for Submission
- Chronic Condition
H01.125 is a billable ICD-10-CM diagnosis code for discoid lupus erythematosus of left lower eyelid. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 124 through 125. Coders also document this condition as discoid lupus erythematosus of eyelid. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cornea and external disease, Oculofacial plastics and orbital conditions, and Systemic lupus erythematosus and connective tissue disorders.
H01.125 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 317 for payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
H01.125 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Discoid lupus erythematosus of eyelid
- Discoid lupus erythematosus of left lower eyelid
- Discoid lupus erythematosus of lower eyelid
- Noninfectious dermatosis of eyelid
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to H01.125: its own notes plus those printed at block H00-H05 and Chapter 7. A note printed at a category, block or chapter applies to every code under it.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may 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)
Notes
General instructions on how these codes are used.
- Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name H01.125, its category, or a range that includes it.
Excludes2 3
These codes carry an Excludes2 note naming H01.125: its condition is not part of those codes, and both may be reported when the patient has both.
- L23 Allergic contact dermatitisdermatitis of eyelid (H01.1-) names H01.1-, which includes this code
- L24 Irritant contact dermatitisdermatitis of eyelid (H01.1-) names H01.1-, which includes this code
- L25 Unspecified contact dermatitisdermatitis of eyelid (H01.1-) names H01.1-, which includes this code
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Eyelid Disorders
Eyelid disorders include a variety of conditions that affect your eyelids. Your eyelids protect your eyes and help keep them healthy. When you blink, they spread tears across your eyes and help wash away dirt or dust. You also close your eyelids when something comes near your eyes to protect them from injury.
The full article covers:
- What are eyelid disorders?
- What causes eyelid disorders?
- What are common eyelid disorders?
- What are the symptoms of eyelid disorders?
- How are eyelid disorders diagnosed?
- How are eyelid disorders treated?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert H01.125 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About H01.125Overview
What is the ICD-10 code for discoid lupus erythematosus of left lower eyelid?
The ICD-10-CM code for discoid lupus erythematosus of left lower eyelid is H01.125 (sometimes written as H01125). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is H01.125 (Discoid lupus erythematosus of eyelid) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report discoid lupus erythematosus of left lower eyelid on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does H01.125 group to?
When discoid lupus erythematosus of left lower eyelid is the principal diagnosis on an inpatient stay, it groups to MS-DRG 125, 124, with relative weights from 0.7699 to 1.2470 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of H01.125?
Under the General Equivalence Mappings, discoid lupus erythematosus of left lower eyelid converts to ICD-9-CM 373.34 (disc lup erythematos lid). The mapping is approximate, so confirm the match fits the documentation.
Does H01.125 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage: H01.125 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 317 (Discoid Lupus Erythematosus).
