2026 ICD-10-CM Diagnosis Code H04.69Other changes of lacrimal passages

ICD-10-CM Codes›H00–H59›H00-H05›H04

ICD-10-CM H04.69
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H04.69 is a billable ICD-10-CM diagnosis code for other changes of lacrimal passages. 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 acquired displacement of punctum lacrimale. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Oculofacial plastics and orbital conditions.

Code Identity

ICD-10-CM Code
H04.69
Billable Status
Yes — Valid for Submission
Code Describes
Other changes of lacrimal passages
Short Description
Other changes of lacrimal passages
Same as the full description in the CMS dataset.
Parent Code
H04.6
Other changes of lacrimal passages

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH00-H05Disorders of eyelid, lacrimal system and orbit
CategoryH04Disorders of lacrimal system
This CodeH04.69Other changes of lacrimal passages

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acquired displacement of punctum lacrimale
  • Ciliated lacrimal caruncle
  • Injection of caruncle of eye
  • Lacrimal caruncle finding
  • Lacrimal sac swollen
  • Reactive lymphoid hyperplasia of lacrimal drainage system
  • Scarring of caruncle of eye
  • Swollen lacrimal sac - solid

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Disorder(of)
      • lacrimal system
        • changes

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

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 H04.69 to ICD-9-CMHistory

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

ICD-9-CM
375.69 Lacrim passge change NEC
Exact Match The mapping is direct, with no qualifiers.

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 H04.69Overview

Is H04.69 (Other changes of lacrimal passages) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other changes of lacrimal passages on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does H04.69 group to?

When other changes of lacrimal passages 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 H04.69?

Under the General Equivalence Mappings, other changes of lacrimal passages converts to ICD-9-CM 375.69 (lacrim passge change NEC). The mapping is a direct match.

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.