2027 ICD-10-CM Diagnosis Code H04.559Acquired stenosis of unspecified nasolacrimal duct

ICD-10-CM Codes›H00–H59›H00-H05›H04

ICD-10-CM H04.559
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H04.559 is a billable ICD-10-CM diagnosis code for acquired stenosis of unspecified nasolacrimal duct. 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 acquired nasolacrimal duct obstruction. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Oculofacial plastics and orbital conditions.

Code Identity

ICD-10-CM Code
H04.559
Billable Status
Yes — Valid for Submission
Code Describes
Acquired stenosis of unspecified nasolacrimal duct
Short Description
Acquired stenosis of unspecified nasolacrimal duct
Same as the full description in the CMS dataset.
Parent Code
H04.55
Acquired stenosis of nasolacrimal duct

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH00-H05Disorders of eyelid, lacrimal system and orbit
CategoryH04Disorders of lacrimal system
This CodeH04.559Acquired stenosis of unspecified nasolacrimal duct

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acquired nasolacrimal duct obstruction
  • Acquired stenosis of nasolacrimal duct
  • Functional nasolacrimal duct obstruction
  • Obstruction of nasolacrimal duct
  • Primary acquired nasolacrimal duct obstruction
  • Secondary acquired nasolacrimal duct obstruction
  • Stenosis of nasolacrimal duct

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H04.559: its own notes plus those printed at H04, block H00-H05, and Chapter 7. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From H04 Disorders of lacrimal system applies to 120 codes
  • congenital malformations of lacrimal system (Q10.4-Q10.6)

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.

From Block H00-H05 Disorders of eyelid, lacrimal system and orbit applies to 574 codes
From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • 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.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • 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.

Clinical ClassificationClinical

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

CCSR EYE008
Oculofacial plastics and orbital conditions
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Tears

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Read the full article at MedlinePlus

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

Convert H04.559 to ICD-9-CMHistory

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

ICD-9-CM
375.56 Acq nasolacrml stenosis
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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About H04.559Overview

What is the ICD-10 code for acquired stenosis of unspecified nasolacrimal duct?

The ICD-10-CM code for acquired stenosis of unspecified nasolacrimal duct is H04.559 (sometimes written as H04559). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H04.559 (Acquired stenosis of nasolacrimal duct) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report acquired stenosis of unspecified nasolacrimal duct on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does H04.559 group to?

When acquired stenosis of unspecified nasolacrimal duct 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 H04.559?

Under the General Equivalence Mappings, acquired stenosis of unspecified nasolacrimal duct converts to ICD-9-CM 375.56 (acq nasolacrml stenosis). The mapping is approximate, so confirm the match fits the documentation.