ICD-10 Code H04.539

Neonatal obstruction of unspecified nasolacrimal duct

Version 2019 Billable Code Perinatal/newborn Diagnoses

Valid for Submission

H04.539 is a billable code used to specify a medical diagnosis of neonatal obstruction of unspecified nasolacrimal duct. The code is valid for the year 2020 for the submission of HIPAA-covered transactions.

ICD-10: H04.539
Short Description:Neonatal obstruction of unspecified nasolacrimal duct
Long Description:Neonatal obstruction of unspecified nasolacrimal duct

Code Classification

  • Diseases of the eye and adnexa (H00–H59)
    • Disorders of eyelid, lacrimal system and orbit (H00-H05)
      • Disorders of lacrimal system (H04)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (first year ICD-10-CM implemented into the HIPAA mandated code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Medical Professionals

Code Edits

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

  • Perinatal/Newborn diagnoses - Newborn. Age of 0 years; a subset of diagnoses intended only for newborns and neonates (e.g., fetal distress, perinatal jaundice).

Diagnostic Related Groups

The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). The diagnosis code H04.539 is grouped in the following groups for version MS-DRG V37.0 applicable from 10/01/2020 through 09/30/2020.

  • 124 - OTHER DISORDERS OF THE EYE WITH MCC
  • 125 - OTHER DISORDERS OF THE EYE WITHOUT MCC

Convert H04.539 to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • 375.55 - Neonatal nasolacrml obst (Approximate Flag)

Synonyms

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

  • Acquired nasolacrimal duct obstruction
  • Neonatal obstruction of nasolacrimal duct
  • Obstruction of nasolacrimal duct

Information for Patients


Tears

You may only think of tears as those salty drops that fall from your eyes when you cry. Actually, your tears clean your eyes every time you blink. Tears also keep your eyes moist, which is important for your vision.

Tear glands produce tears, and tear ducts carry the tears from the glands to the surface of your eye. Problems with the tear system can include too many tears, too few tears, or problems with the tear ducts. Treatment of the problem depends on the cause.


[Learn More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.