2026 ICD-10-CM Diagnosis Code H25.811Combined forms of age-related cataract, right eye

ICD-10-CM Codes›H00–H59›H25-H28›H25

ICD-10-CM H25.811
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H25.811 is a billable ICD-10-CM diagnosis code for combined forms of age-related cataract, right 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. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124). Coders also document this condition as combined form of senile cataract. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cataract and other lens disorders.

Code Identity

ICD-10-CM Code
H25.811
Billable Status
Yes — Valid for Submission
Code Describes
Combined forms of age-related cataract, right eye
Short Description
Combined forms of age-related cataract, right eye
Same as the full description in the CMS dataset.
Parent Code
H25.81
Combined forms of age-related cataract

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH25-H28Disorders of lens
CategoryH25Age-related cataract
This CodeH25.811Combined forms of age-related cataract, right eye

Code EditsBilling

Medicare Code Editor checks that affect claim validity for H25.811.

Adult diagnoses
The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Combined form of senile cataract
  • Senile combined form cataract of right eye

Clinical ClassificationClinical

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

CCSR EYE002
Cataract and other lens disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Cataract

A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.

Read the full article at MedlinePlus

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

Convert H25.811 to ICD-9-CMHistory

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

ICD-9-CM
366.19 Senile cataract NEC
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 H25.811Overview

Is H25.811 (Combined forms of age-related cataract) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report combined forms of age-related cataract, right eye on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does H25.811 group to?

When combined forms of age-related cataract, right 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.

Who can H25.811 be reported for?

The Medicare Code Editor checks combined forms of age-related cataract, right eye against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.

What is the ICD-9 equivalent of H25.811?

Under the General Equivalence Mappings, combined forms of age-related cataract, right eye converts to ICD-9-CM 366.19 (senile cataract NEC). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.