2027 ICD-10-CM Diagnosis Code H21.40Pupillary membranes, unspecified eye

ICD-10-CM Codes›H00–H59›H15-H22›H21

ICD-10-CM H21.40
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H21.40 is a billable ICD-10-CM diagnosis code for pupillary membranes, unspecified eye. 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 adhesion of pupillary membrane. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified eye disorders.

Code Identity

ICD-10-CM Code
H21.40
Billable Status
Yes — Valid for Submission
Code Describes
Pupillary membranes, unspecified eye
Short Description
Pupillary membranes, unspecified eye
Same as the full description in the CMS dataset.
Parent Code
H21.4
Pupillary membranes

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH15-H22Disorders of sclera, cornea, iris and ciliary body
CategoryH21Other disorders of iris and ciliary body
This CodeH21.40Pupillary membranes, unspecified eye

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Adhesion of pupillary membrane
  • Iris bombé
  • Occlusion of pupil
  • Rupture of pupillary membrane

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H21.40: its own notes plus those printed at H21.4, H21, 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 H21.4 Pupillary membranes applies to 4 codes
  • congenital pupillary membranes (Q13.8)

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 H21 Other disorders of iris and ciliary body applies to 97 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 EYE012
Other specified eye disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Eye Diseases

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The full article covers:

  • What diseases can affect the eye?
  • What are the symptoms of eye diseases?
  • Who is more likely to develop eye diseases?
  • What are the treatments for eye diseases?
  • Can eye diseases be prevented?

Read the full article at MedlinePlus

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

Convert H21.40 to ICD-9-CMHistory

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

ICD-9-CM
364.74 Pupillary membranes
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 H21.40Overview

What is the ICD-10 code for pupillary membranes, unspecified eye?

The ICD-10-CM code for pupillary membranes, unspecified eye is H21.40 (sometimes written as H2140). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H21.40 (Pupillary membranes) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report pupillary membranes, unspecified eye on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does H21.40 group to?

When pupillary membranes, unspecified eye 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.

Can H21.40 be reported with Q13.8?

Not as a rule. The Excludes1 note at H21.4, which applies to H21.40, lists "congenital pupillary membranes (Q13.8)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What is the ICD-9 equivalent of H21.40?

Under the General Equivalence Mappings, pupillary membranes, unspecified eye converts to ICD-9-CM 364.74 (pupillary membranes). The mapping is approximate, so confirm the match fits the documentation.