2026 ICD-10-CM Diagnosis Code H04.211Epiphora due to excess lacrimation, right lacrimal gland

ICD-10-CM Codes›H00–H59›H00-H05›H04

ICD-10-CM H04.211
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H04.211 is a billable ICD-10-CM diagnosis code for epiphora due to excess lacrimation, right lacrimal gland. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 124 through 125. Coders also document this condition as epiphora due to excess lacrimation. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cornea and external disease and Oculofacial plastics and orbital conditions.

Code Identity

ICD-10-CM Code
H04.211
Billable Status
Yes — Valid for Submission
Code Describes
Epiphora due to excess lacrimation, right lacrimal gland
Short Description
Epiphora due to excess lacrimation, right lacrimal gland
Same as the full description in the CMS dataset.
Parent Code
H04.21
Epiphora due to excess lacrimation

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH00-H05Disorders of eyelid, lacrimal system and orbit
CategoryH04Disorders of lacrimal system
This CodeH04.211Epiphora due to excess lacrimation, right lacrimal gland

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Epiphora due to excess lacrimation
  • Epiphora of right eye
  • Epiphora of right eye due to excessive tear production

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR EYE001
Cornea and external disease
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR EYE008
Oculofacial plastics and orbital conditions
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

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.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert H04.211 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
375.21 Epiphora d/t excess tear
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About H04.211Overview

Is H04.211 (Epiphora due to excess lacrimation) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report epiphora due to excess lacrimation, right lacrimal gland on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does H04.211 group to?

When epiphora due to excess lacrimation, right lacrimal gland is the principal diagnosis on an inpatient stay, it groups to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of H04.211?

Under the General Equivalence Mappings, epiphora due to excess lacrimation, right lacrimal gland converts to ICD-9-CM 375.21 (epiphora d/t excess tear). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.