2026 ICD-10-CM Diagnosis Code H16.242Ophthalmia nodosa, left eye

ICD-10-CM Codes›H00–H59›H15-H22›H16

ICD-10-CM H16.242
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H16.242 is a billable ICD-10-CM diagnosis code for ophthalmia nodosa, left eye. 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 left ophthalmia nodosa. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cornea and external disease.

Code Identity

ICD-10-CM Code
H16.242
Billable Status
Yes — Valid for Submission
Code Describes
Ophthalmia nodosa, left eye
Short Description
Ophthalmia nodosa, left eye
Same as the full description in the CMS dataset.
Parent Code
H16.24
Ophthalmia nodosa

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH15-H22Disorders of sclera, cornea, iris and ciliary body
CategoryH16Keratitis
This CodeH16.242Ophthalmia nodosa, left eye

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Left ophthalmia nodosa
  • Ophthalmia nodosa

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

Patient EducationClinical

Corneal Disorders

Your cornea is the outermost layer of your eye. It is clear and shaped like a dome. The cornea helps to shield the rest of the eye from germs, dust, and other harmful matter. It also helps your eye to focus. If you wear contact lenses, they float on top of your corneas.

Read the full article at MedlinePlus

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Convert H16.242 to ICD-9-CMHistory

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

ICD-9-CM
360.14 Ophthalmia nodosa
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 H16.242Overview

Is H16.242 (Ophthalmia nodosa) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report ophthalmia nodosa, left eye on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does H16.242 group to?

When ophthalmia nodosa, left eye 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 H16.242?

Under the General Equivalence Mappings, ophthalmia nodosa, left eye converts to ICD-9-CM 360.14 (ophthalmia nodosa). 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.